first-time attendee sessionforms.acsm.org/summit2016/pdf/16hfse all handouts.pdf · walking...

First-Time Attendee Session

Maximizing Your Summit Experience

1

Celebrating 20 GREAT YEARS of Health and Fitness!!!!

2

Katie Smith, Ph.D., RDN, LD Mercy Medical Center, Des Moines, Iowa

Melissa Layne, M.Ed. University of North Georgia

Christian Thompson, Ph.D. University of San Francisco

3

A Welcome From The Conference Chairman

Mike Spezzano

4

Let’s Get to Know Each Other

Nice to meet you!

Meet 2 people you don’t know

How many 1st time attendees?

ACSM’s HFS 20th Anniversary • An official “Summit Jumping Jack” selfie

station set up in the expo • A Team boot camp challenge event • Photos and video shorts broadcast throughout

the meeting featuring past Summit highlights • Long-time attendees to be honored on-site

6

Search for ACSM Conferences and Meetings on your App Store

Set up profile, engage other attendees, speakers

Access schedule, outlines View daily news releases Evaluate sessions, workouts

Summit Information and Communication – Mobile App

7

On-site Program & Expo Guide Get and print session outlines,

schedule: o forms.acsm.org/summit2016 o Available until May 14, 2016

Social media: o Twitter: @ACSMNews #ACSMSummit16 o Facebook: “Like” ACSM o Instagram: tag ACSM

▫ @ACSM1954 ▫ #ACSMSummit16

Summit Information and Communication

8

ACSM CECs: 24 (entire conference) ACE CECs: 2.4 Pre-conference Sessions, ACSM CECs:

o Worksite Health Promotion: 5 CECs o Leading-Edge Exercise Programs for Adults: 4

CECs o Exercise Programming for Older Adults: 4 CECs o Sports Nutrition: 4 CECs o Foam Rolling: 7.5 CECs o BOSU Certification: 8 CECs o EIM Credential: 8 CECs

Continuing Education Credits

9

4-6 weeks after Summit will receive email with link to ACSM CEC verification system; can print and save CEC certificate

Log in to your account by clicking on “My ACSM” at the top of the page (acsm.org)

Never logged in before? o Log-in is first three letters of your last

name plus your ID number o Password is your ID number

http://acsmsummit.org/programming/cecs/

Continuing Education Credits

Network with attendees and faculty Don’t be shy . . . introduce yourself to > 1

person at each session Exchange business cards Network with colleagues in sessions, expo

hall, hallways, social events, workouts Session: Networking for Success 1x: Wed. 9:30-10:30am

Networking The Original Social Media

10

1. Plan your sessions in advance - get to presentations early!

2. List the top 10 questions you want answered

3. Use sessions to broaden your interests, while enjoying sessions in your area

4. When you get an idea during a session, write it down.

11

Maximizing the Learning Experience

1. 3 Keynote Lectures 2. Breakout Sessions 3. Hot Topic Panels 4. Workshops 5. Master Class Workouts

Understanding the Program: Session Types

12

1. Speakers present to share information, ideas

2. Don’t feel intimidated to ask questions during a session

3. Don’t be shy about talking to presenters

4. Ask presenters if you can follow-up with questions

5. Ask to schedule time to talk later if really interested

Interacting with Presenters

13

Don’t miss Keynotes! 12 tracks (10 plus workouts &

workshops); review all track offerings in each time slot

Check out “Interactive Workshop” track; includes a practical element

Decide on Must See sessions Most lectures repeat except those

with “1X” after title are presented only once

Program Tips

14

15

Keynote Sessions

The Happiness Epidemic- Catch It If You Can

Petra Kolber Today 5:30-6:30 pm

Positioning Lifestyle and Physical Activity as Effective Treatments for

Obesity John M. Jakicic, Ph.D., FACSM Wednesday 8:15-9:15 am

16

Keynote Sessions

Larry Golding Lecture- Exercise is Medicine:

Development to Implementation

Elizabeth A. Joy, M.D., M.P.H., FACSM Thursday 8:15-9:15 am

Other Featured Sessions • Dr. Bortz Lecture on Healthy Aging

– “Act Your Age: Resistance Training for Healthy Aging” – Nicholas Beltz and Jeffrey Janot – 1x session: Wed. 4:15-5:15pm

• US Surgeon General’s Call to Action – Promote Walking and Walkable Communities – Dr. David Brown from the CDC – 1x session: Wed. 5:30-6:30pm

18

Workouts

12:00pm - 1:00pm

5:30- 6:30pm + Team Bootcamp Propel event 7-8pm

6:45am - 7:45am

12:00pm - 1:00pm

5:30pm - 6:30pm

6:45am - 7:45am

6:45am - 7:45am

WEDNESDAY

FRIDAY

THURSDAY

2:30pm - 3:30pm

10:45 – 11:45am

2:30pm - 3:30pm

1. Must have signed up in advance for all workout sessions via web

2. If not registered, can wait in stand-by

line outside room. If space, first come, first served allowed in by room monitors

3. Need to show your name badge upon

entry

Workout Registrations

19

• Exercise Professional’s Scope of Practice • Thurs. 5:30-6:30 pm • Members of ACSM’s CCRB

• Committee for Certification and Registry Boards • Extreme Sports and Exercise: What are the

Limits? • Thurs. 7-8 pm • Features Len Kravitz, Dixie Stanforth, Steve

Blivin

Hot Topic Panel Discussions

20

Expo Hours: o Today 6:30-8:00, Welcome Reception o Wed. 11:30-3:00, 5:00-7:00pm o Thur. 11:30-2:30

Vendors are important supporters of ACSM and the Summit experience

All attendees are welcome:

o Stop in between sessions & check out vendors o Meet friends o Network o Complimentary beverages o Giveaways each day! o Demos each day- see program for agenda o Download app for alerts on demos & giveaways

Visit The Expo Hall

21

• Wednesday, March 30, 7-8pm • Hilton Grand Ballroom Salon V • Attendees arrive by 6:45pm to get

into your teams. Check-in at the doors starting at 6:30pm

• Pre-registration sent via email in March. Didn’t register? A stand-by line will allow more participants if spots are available

Take Part in The Summit! PROPEL

“Sweating Through The Ages” Team Bootcamp Challenge

22

IAWHP Reception & Business Meeting

• International Association for Worksite Health Promotion

• Today! 4-5:30pm • Dedicated to serving and

advancing the worksite health promotion practitioner

• Go to network and learn how IAWHP can benefit you

Free Breakfast!

• Sponsored by General Mills Institute of Health and Nutrition

• Featuring General Mills products: cereals, Yoplait, etc.

• Thursday 7:45-8:15 am • Limited quantity- first 250 attendees • Room: Salon III

• Wear Your Name Badge At All Times • No Photography or Videotaping

During Sessions

Friendly Reminders

25

27

Have a Great Conference!

20 YEARS OLD AND STILL GOING STRONG!!!

Express Yourself Abbie Appel ACSM Health and Fitness Summit and Expo – Orlando 2016

www.abbieappel.com [email protected]

Benefits

• Less Attention needed (shorter attention span) • Shorter workouts are better than nothing – training intensely for 30 minutes can provide a lot of

physiological and psychological benefits – easier to handle because its for a shorter amount of time • Directors it also allows you to get more formats on the schedule (2 – 30 minute complimenting workouts) • Must use time wisely • Overcome boredom • Great for instructors because there’s less thinking involving (simpler, shorter workouts – less prep time)

I. Objectives

A. Provide you with 3 different intense 30 minute workouts B. Short Warm-Up for each C. 20 – 23 minute workout D. Abs/Core training unless we do a lot of stability workout in the segment (abs work automatically) E. Cool-down

II. Equipment – Limited amount of time (rather than pulling out a lot of equipment – use only one) use time

efficient

III. Formats of each segment A. Boot Camp – 2 sets

1. Develop Coordination 2. Strength

B. Cardio Circuit with a super set of strength training 1. Simple Cardio Drill 2. Simple Strength exercise 3. Super Set – one upper and lower body exercise back to back

C. Total Body exercises 1. Compound exercises that integrate more than one body part 2. Posture 3. Strength 4. Balance

IV. Goal of this workout

A. Get the job done quickly, effectively and safely B. Utilize User-friendly exercises – not hard to follow or much to think about (P90X) C. Time-efficient – get more done in less amount of time – burn more calories, fat etc.

1. Interval Training a. 2 segments of varied intensity (short burst of high intensity training) b. Higher intensity workout c. More done in less amount of time

2. Circuit Workouts a. 2 segments – same intensity (cardio/strength) b. Get more done in less amount of time

3. Total-Body workout a. Focusing on more than area of the body b. Higher intensity c. More done in less amount of time

http://www.abbieappel.com/

mailto:[email protected]

KICKBOXING KRYPTONITE

Melissa Layne, MEd.

TAKEAWAY:

1) HIIT classes are the rage! 2) Intensity changes cater to both your rookies and your veterans.

3) Location, location, location – change the positions of your participants.

Lo WARMUP – Hustle front and back (8) , want it– can’t have it 2x(8)Grape right and Left (8) SSD Hamstrings (8) and reverse

KICKBOX #1 – Walk front four , any four single tempo punches (8), walk back four and 2 front push kicks (8), shuffle Right and 4 side jabs high lo high lo (8) reverse shuffle and side jabs to left (8) Reverse entire 32

HIIT INTERVAL – Skater’s leaps (for an added challenge; skater leaps into power skips)

KICKBOX #2 – Repetition reduction leading to final combo of 2 jabs high, 2 jabs low to floor and 2 alternating NO knee head slams

KICKBOX #3 – 4 front push kicks into squats and 4 washing machines – back left leg then pushes through to repeat the entire 32 count combo

HITT INTERVAL – MINI SQUAT JUMPS – LOAD ECCENTRICALLY

KICKBOX #4 – Eight Adam’s Apple blocks, 8 rib cage blocks, 8 trip-ems, 8 rib cage blocks (all alternate). Walk 4 to right corner and four cross jabs, walk four back and speed bag boxer’s feet to reverse to left.

HIIT INTERVAL – AEROBIC CHAMPIONSHIP JACKS ON 4.

KICKBOX #5 –Tap right foot front with hip rotation and jab, tap right foot side with hip stabilization and jab (2x)-4 jacks. Reverse to other side.

HIIT INTERVAL – POWER SKIPS

CHALLENGE KICKBOX – jab, cross, hook, upper, double jab squat, knee, kick set set and reverse!

HIIT INTERVAL – JUMP LUNGES

COOLDOWN – 4 knife throws and 4 mambos with a block high to the front and low to the back

THANKS FOR STAYING AND PLAYING! SEE YOU IN 2017!

Workout Outline ACSM Health and Fitness Summit 2016

Power Walk

Michele Stanten Lee Scott Thereʼs more than one way to walk! This outdoor session will turn an everyday activity into four fun, heart-pumping, body-toning workouts with variations to create more unique walking programs. Get ready to sweat as you discover how to make walking a vigorous workout. Despite the higher intensity, these workouts are still joint-friendly and can be modified to all fitness levels simultaneously. Walking isnʼt just for those who are elderly, unfit, or obese. This medley of walking workouts includes traditional high-intensity intervals with a twist, toning walks using a resistance band, walking boot camp, and fun walking drills. Youʼll learn how to create fun, walking workouts that wonʼt intimidate beginning exercisers while still giving your fitter clients a good workout. I) Introduction

• Whatʼs up with walking (Surgeon Generalʼs Call to Action, Every Body Walks Collaborative, Walking Wednesdays)

• Essential elements for a safe and successful outdoor walking class

• Class structure and program development II) Walking technique

• Progression 1 (Upper body focus): Bring eyes up to focus energy over the ground, not into it. Bend arms to reduce resistance of a long lever arm—allows for a faster arm cadence, which results in faster leg cadence.

• Progression 2 (Lower body focus): Shorten the length of the front step to increase step cadence. A heel strike with toe lift facilitates a full range of motion around the ankle joint.

• Progression 3 (Posterior muscle chain recruitment): Pull back with arms to recruit power of large muscles in the back. Engage glutes on leg movement from heel strike to toe push-off.

• Progression 4 (Complex recruitment of core muscles for pelvic movement): Walk a plank (i.e. foot placement) and allow pelvic motion to lengthen stride as each leg moves behind you.

Workout Outline ACSM Health and Fitness Summit 2016

III) Walking Workouts

1) HIIT Walks

2) Toning Walks with a Band

3) Walking Boot Camp

4) Fun Drills

Resources

5 Ways to Use Walking to Grow Your Business http://www.acefitness.org/blog/3699/5-ways-to-use-walking-to-grow-your-business

Why You Should Tell Your Clients to Walk More https://www.acefitness.org/blog/5348/why-you-should-tell-your-clients-to-walk-more

Walk the Talk: A Fitness Professionalʼs Guide to Developing Walking Programs, American Council on Exercise (ACE) https://www.acefitness.org/advocacy/pdf/Walking_Toolkit_Pro.pdf

Iknoian, Therese, Fitness Walking. Human Kinetics, 2005.

Meyers, Casey, Walking: A Complete Guide to the Complete Exercise. Ballantine Books, 2007.

Scott, Lee, Simple Secrets for a Great Walking Workout (DVD), 2006.

Stanten, Michele, Walk Off Weight. Rodale Inc, 2010.

THANK YOU!!!

Michele Stanten Lee Scott [email protected] [email protected] mywalkingcoach.com wowpowerwalking.com

WERD ACSM Summit Outline 2016 1

“What is the Best Athletic Shoe?” Update 2016 -Summary-

ACSM Summit March 30, 2016

Matt Werd, DPM Fellow: American College of Sports Medicine

Past President: American Academy of Podiatric Sports Medicine Lakeland, Florida [email protected]

Disclosure: No disclosures or conflicts to report

Question: “What is the Best Athletic Shoe?”

Answer: “It Depends… on a number of factors!”

Factors to consider for finding the “Best” athletic shoe: Each athlete is unique and requires different shoe features based on,

- Injury history - Training goals & philosophy - Running gait pattern - Foot strike pattern - Weekly miles/hours of training - Training surfaces - Requirements of the Sport (ie Running=straight in-line, vs tennis=side-to-side, etc) - Examination of footwear technology - Experience with previous shoe models - Noticeable wear-patterns on prior shoes - Ranges of motion - Body Mass Index - Comfortable fit - Cost

Additional factors affecting athletic shoe performance: Lacing, Inserts, and Socks contribute to proper fit and function

>Lacing: Proper shoe lacing techniques will enhance shoe fit >Inserts: Over-the-counter

+Pros: Initial treatment, dispensed on-site, inexpensive, and easily modified -Cons: Non-custom fit

Custom Foot Orthoses

+Pros: Evidence-Based research, custom-fit, numerous modifications, rigid or flexible -Cons: Require casting/scanner, expensive, time-consuming

>Socks: Acrylic materials control moisture better than cotton, compression


Trends 1970-1985 Focus: cushion materials (Air, Gel) 1985-2000 Focus: “motion-control” (Roll-Bar, block motion) 2000-2010 Focus: biomechanics through gait cycle (IGS, Progressive posting) 2010-2015 Focus: barefoot running, minimalist shoes, toning Shoes 2016-Future So, What's New??...

Update 2016 *Paradigm shift from: matching the athletic shoe with the foot type, to: matching the athletic shoe with the athlete’s sport demand, experience and fitness level -Evaluate running form, biomechanics, and foot strike pattern -Consider the shoe’s “Drop” (also called “ramp angle”) from heel-to-toe

>Ideal shoe drop is yet to be determined- numerous factors such as foot biomechanics and pathology >Traditional running shoes have a 10-12mm drop >“Minimalist” and barefoot-type shoes have zero-drop

-“Maximalist, highly-cushioned shoes” exponential sales-growth -Consider the amount of midsole cushioning, varies between 2-36mm thickness -Consider the midsole material: higher durometer = harder material; lower durometer = softer -Construction of shoe platform, incorporated uppers -Gender-specific lasts

*Here are a few examples of emerging shoe companies to be aware: HOKA One One-

Maximum cushioned (24-36mm midsole) shoes with 4-6mm drop Rocker-type outsole platform, incorporated upper

Altra -

All models are zero-drop and extra-wide forefoot, male/female lasts Specific model with 2-degree varus post throughout midsole

Newton –

Forefoot lugs geared for “Natural Running” on the ball of the foot


Additional Tips -Shopping at run-specialty stores (IRRA-Member) will increase the likelihood of getting the proper shoe with correct fit by trained personnel -When an injury is involved, it is important to consider the most appropriate shoe, and also realize that shoes are only one of the contributing factor with injuries; all other factors must be addressed as well! -Shop for shoes later in the day, as feet tend to swell as the day progresses -Measure foot size every time purchasing shoes: check both length and width of both feet -Regularly strengthen intrinsic foot muscles -Transition gradually, if selecting a new type shoe or adapting a new running-style

Key Take Home Points -Shoe fit and feel are critical -Understand new shoe technologies and how they affect performance -Understand new shoe terminology -Keep current with constantly changing features and trends -Be aware of other factors affecting performance and injury

References Athletic Footwear and Orthoses in Sports Medicine, 2nd Edition, WERD MB, Knight EL, Langer P; Springer, New York City, In publication for 2016 release. Athletic Footwear and Orthoses in Sports Medicine, 1st Edition, WERD MB, Knight EL; Springer, New York City, 2010. WERD MB, Knight EL; FOOT! Care, Prevention, and Treatment, Published by ISC Division of Wellness, 1st Edition January 2004, 2nd Edition January 2008. www.AAPSM.org https://www.acsm.org/docs/brochures/running-shoes.pdf

Title: An Internet-based Nutrition and Physical Activity Intervention for Overweight/Obese Adults Background: Attenuating the obesity epidemic is a public health priority. This topic will discuss the latest research in the field of obesity, specifically focusing on behavior change techniques used in a 16-week, online intervention protocol. Specific emphasis will be placed on how to implement the program and ways in which various populations can benefit from it. Purpose: To disseminate the latest research in obesity, specifically focusing on an online intervention as a means to create healthy lifestyle modifications in obese adults and children. Objectives: By the conclusion of the program, participants will be able to:

1. Understand the latest research in obesity medicine 2. Understand the need for a robust online nutrition and physical activity

platform to track behavior change 3. Describe the various behavior change models used in a successful online

weight loss program 4. Understand the motivation behind your clients goals before making a

change 5. Utilize a week-by-week approach with regular online coaching sessions in

order to increase compliance. 6. Implement a child and/or adult behavior change program within various

demographics and socio-economic communities 7. Explain the benefits/consequences of convenience foods in a weight loss

program 8. Create a life-long lifestyle plan for an obese community, population

DIET SMACK-DOWN: Vegan vs. Paleo By Zonya Foco, RD, CSP

Wednesday March 30, @ 9:30 am and 2:30 pm

Should we eat vegetarian, or like a caveman? With wheat and dairy or without? With so many opposing endorsements, what’s the best choice? In an effort to truly understand the pro’s and con’s of each diet, Zonya reports on her personal study where she subjected herself to eating Vegan for 30 days, followed by eating Paleo for 30 days. She presents not only what she ate and how she felt, but also the changes in her weight, body fat percent, blood cholesterol, HDL, LDL & triglycerides after each diet, as well as a comprehensive dietary analysis of each. How easy was each diet? What impact did each have? Did each provide all the necessary nutrients? You will leave with a firm understanding of the benefits and shortcomings of each diet, helping you to help others avoid potential pitfalls of each diet, and also take the best from each approach, creating a realistic and successful eating style for life.

After attending this session, participants will be able to:

1) Explain the strengths and weaknesses of each of the two rigid eating styles. 2) Advise clients how to avoid common pitfalls of both diets, to ensure they are a

healthy “vegan” or “palean.” 3) Teach a blended “pagen” eating style that captures the strengths of both, for a less

restrictive and more realistic eating pattern that the entire family can enjoy.

Outline I. What the Vegan Diet is

a. Strengths b. Weaknesses c. Popular books and authors d. What is the extent of the body of research?

II. What the Paleo Diet is


III. Analysis of my 30-day experiment on each diet

a. Nutrition analysis: what did each diet lack? b. Weight and BF% changes c. Lipid profile changes d. “enjoyment” factor of each

e. Which one would I like to live for the rest of my life?

IV. Analysis of a blended, no processed foods “pagen” eating style a. Nutrition analysis: is it more complete than either of the above? b. Is it more enjoyable long term? c. Does it give the same health benefits?

V. Group Discussion and Q/A

a. What provides the successful weight loss component of each diet? b. What is it that provides the successful improvements in health? Including

inflammatory diseases?

VI. Conclusions a. Three cautions for people eating Paleo b. Three cautions for people eating Vegan c. A blended approach that’s simple to teach, and easy to live, especially for

the whole family.

Exercise for those Living with Cancer: A Field Guide for Exercise Professionals

Kathryn Schmitz, PhD, MPH, FACSM, VP ACSM

March 21, 2016

1. Cancer 101 a. Definitions and Statistics b. What is cancer? c. How is it diagnosed? d. How is it treated? e. Symptoms, side effects, long term and late effects f. Financial effects of cancer g. Time for questions

2. Review the evidence base for prescribing exercise after cancer a. Meta analyses

i. What we know ii. What we DON’T know yet

3. Practical considerations a. Published guidelines

i. Who do they apply to? b. Pre-exercise evaluations c. Safety considerations d. Scope of practice e. Case Studies with discussion

i. Breast ii. Prostate

iii. Colon iv. Endometrial v. Bladder

f. Questions 4. Closing

1

MAKE CONTACTS TO BUILD RELATIONSHIPS: NETWORKING FOR SUCCESS IN A WORLD OF OPPORTUNITIES

Presented by Fred Hoffman, M.Ed. I. WHERE AND WHEN TO MAKE CONTACTS AND NETWORK A. Anywhere, anytime 1. You meet and talk to people everywhere - Waiting in line, on a bus, metro or plane - At a party, social gathering or celebration - Place of worship - Work-related events and social gatherings - Online - When and where you least expect it II. WORK-SPECIFIC PROFESSIONAL NETWORKING A. Have a plan! 1. Determine networking ‘goals’ when possible B. Attend a variety of industry events: seminars, workshops, conventions, conferences, tradeshows, health fairs, fund-raisers, focus groups, etc. 1. Become a member of professional industry organizations - Consult their website and publications for upcoming events - Local – National – International 2. Subscribe to online and print publications to learn about upcoming events C. Get involved in industry-related activities 1. Try public speaking (lecture or presentation) 2. Give a free class 3. Volunteer your time at an event - Convention staff - Free access to a large number of people D. Social Media (Facebook, Twitter, Pinterest, LinkedIn, YouTube, etc.) E. Online resources (University website, blogs, forums) F. Virtual Networking III. NETWORKING BASICS A. Introductions, conversations, active listening 1. Formal introductions (by someone, or self-introduction) - Determine how you are going to introduce yourself, and be prepared to articulate the answer to ‘what do you do?’ 2. Getting conversations started - Scan the room for someone to speak to - Introduce yourself - Create small talk - Be curious, ask open-ended questions - Be yourself and be genuine 3. Practice active listening 4. Take risks 5. Prepare for rejection

2

B. Business cards 1. Distributing and Receiving - Never leave home without them - Make a note on each card you receive to remind you of the person and conversation C. Follow-up! 1. Time sensitive 2. E-mail, social networks, phone, ‘snail mail’ 3. Schedule meetings 4. Do what you say you are going to do! 5. Create a relationship! D. Avoiding common mistakes and pitfalls IV. PRESENTING YOURSELF A. Business cards 1. What should appear on your business card? B. Resume, CV, biography C. Photos and videos D. Online 1. Web site or page 2. Blog 3. Social Media a. The different platforms b. Personal profile c. Groups d. Send a message! e. Follow up! V. CAREERS IN THE FITNESS AND WELLNESS INDUSTRIES A. Identify career goals 1. Short and long-term goals 2. Plan of action B. An abundance of employment and career options C. Where to find work opportunities 1. Use your contacts (new and old) 2. The power of the web 3. Industry specific publications, websites, career fairs, trade shows, job boards, networking, word of mouth, etc. D. What are employers looking for? 1. Qualified professionals a. Education b. Current and up to date c. Certifications d. Multiple skills

3

TAKE AWAY MESSAGES: 1. A well-thought-out, professional business card is still essential 2. When meeting someone for the first time, clearly articulate what your job is and what services you offer 3. Social media is excellent for networking when used correctly

. www.fredhoffman.com

E-mail: [email protected] Facebook: www.facebook.com/fred.hoffman

Twitter: fredhoffmanfit LinkedIn: www.linkedin.com/in/fredhoffman

Suspension Exercise: Past, Present and Future ACSM’s 20th Health and Fitness Summit

By: Tony Nuñez, M.S. and Len Kravitz, Ph.D., University of New Mexico 4 Major ‘Takeaways’: (1) a better understanding of the current research in the area of suspension training (ST), specifically in the area of core muscle activation and training adaptations, (2) the present status of ST exercise in the field of exercise science/physiology in regards to energy expenditure and best practices, (3) suitable exercise interventions using a ST device based on a well-rounded and in-depth analysis of the past and present ST research, explicitly in the areas mentioned in Takeaway (1), and (4) as provided in “TRX/Multi-Mode Circuits for ALL Populations and Goals” below, the future of TRX training and research may very likely be Multi-Mode. As you will see, a fifth (5) takeaway is the creativity is unlimited for these circuits. Brief Review: Suspension training exercise has increased in popularity in both the commercial and

strength and conditioning settings. However, the best practices for a ST device are not completely clear. Subsequently noted are the current ST benefits for the general and athletic population (Nunez, TP, Kravitz, L. 2015-updated 2016): improved core stability, increased core activation, increased localized muscle activation compared to traditional movements, improved muscular strength and endurance, flexibility and balance (results similar to that of traditional resistance training programs), beneficial for individuals with low back issues/rehabilitative needs. Two Key Areas of Suspension Training Research (1) Core Activation (2) Suspension vs. Traditional Resistance Exercise/Training NEW Area: (3) Metabolic Cost of Suspension Training Exercise Core Activation TRX Suspended Pushups (Chest Press)—Beach, Howarth, Callaghan (2008)

• Increase abdominal musculature activity for torso stability • Increase latissimus dorsi activity compared to traditional pushups

TRX Inverted Row—Fenwick, Brown, and McGill (2009)

• Increases abdominal and latissimus dorsi activity • Decreases intervertebral joint (IVJ) shear forces compared to the bent over row and

single-arm row exercises • Decrease potential for injury during rowing exercises

TRX Chest Press—McGill, Cannon, Andersen (2014)

• Decrease shear force on IVJ compared to traditional pushups • Can be used as a modification or progression for the pushup exercise

o Three TRX Chest Press angles used: Upright, 60 degrees, and 45 degrees

TRX Plank Variations—Byrne et al. 2014; Snarr and Esco, 2014

• Suspended elbows-in (EI) Planks elicited the greatest mid-torso muscle activation compared to all variations of suspended and traditional ground-based planks

Suspended feet-in (FI) Planks elicited greater mid-torso muscle activation compared to traditional ground-based planks

Low back muscle activation also greatest in suspended EI plank Comparative Training Studies Instability (TRX + BOSU) and Traditional resistance training (TRT) programs—Maté-Muñoz et al. (2014)

• Instability training had an equal improvement on strength, power, movement velocity and jumping ability in untrained individuals following a 7 week training program

• Both the bench press and back squat exercises improved significantly in maximal strength, average and peak velocity, and peak power following the 7 week instability training protocol

• Other major improvements were demonstrated in the Squat Jump and Counter Movement Jump exercises

TRX verse TRT on muscular performance in adults—Janot et al. (2014)

• TRX has an equal improvement on balance, flexibility, upper and lower body strength and core endurance compared to traditional resistance training in untrained young and old adults following a 7 week training program

• Greatest improvements from the TRX Training group came from the abdominal flexor and low back extensor muscular endurance, which was significantly greater than the TRT group

Physiological Abstracts

• Acute TRX exercise bout elicits a growth hormone response similar to an acute traditional resistance exercise bout.

• Acute TRX exercise bout elicits a testosterone response similar to traditional

resistance exercise

• Acute TRX exercise bout elicits a decreased cortisol response compared to an acute traditional resistance exercise bout.

The University of New Mexico Research ST exercise circuit crossover design between two different work interval (WI) protocols and its effect on ventilatory response, energy expenditure, heart rate, total repetitions and rating of perceived exertion (RPE).

• Similar metabolic response for both 45:15-sec and 30:15-sec work-to-rest ratios

• According to %VO2max for both males and females, the acute ST exercise response meets ACSM guidelines for improvements in aerobic capacity

• Males burned more calories compared to females, despite females having higher %VO2max and %HRmax during BOTH protocols

• No significant differences in RPE or total repetitions between males and females

TRX/Multi-Mode Circuits for ALL Populations and Goals

Full Body Strength TRX OH Squat TRX Pushup* TRX Pike* TRX Single-Leg HS Curl TRX Inverted Row TRX Supermans

Full Body Power TRX Squat Jump TRX Plyo-Pushup* TRX Pendulums* TRX Plyo-Knee Drive TRX Power Pull TRX Pull & Twist

Full Body Endurance TRX Knee Drives TRX Chest Fly TRX Rocking Plank* TRX Hamstring Curl* TRX Bent Leg Row TRX Mountain Climber

BEST of the BEST TRX Squat to Row (R&L) TRX Atomic Pushup (FI) TRX Inverted Biceps Curl TRX Hamstring Curl (FI) TRX Row to “I” TRX Oblique Swings (FI)

MM Full Body Strength TRX Overhead Squat BOSU Spiderman Pushups DB Glut Buster TRX Reverse Fly BOSU Single-Leg Hip Bridges DB Curl to Press

MM Full Body Power KB Swing Med Ball Chest Toss Jam Ball Slam DB Push Press TRX Power Pull (R&L) Jam Ball Hip Hinge Toss

MM All Around Health Overhead Squat with Dowel TRX 60-deg Body Row Modified Pushup with Sidewalks (alt) Plank with Hip Extension (alt) Single-Leg Hip Bridge BOSU Scapular Retraction

MM Best of the Best KB Drop Back Lunge Single-arm DB Press on BOSU (R&L) RIP Trainer Rotations (R&L) Jam Ball Slam TRX Power Pull (R&L) High Plank Hand Walkouts

You Built It, So Why Don’t They Come? Mary Kruse MS, ATC President

HealthSource Solutions, Minneapolis, MN [email protected]

Participation vs engagement • Participation: you do it • Engagement: you want to do it

Creating Engagement

• Authentic connections, mutual respect • Strong healthy relationships • Manage expectations • Leaders set the example • Involve others in sharing a common vision • Build on strengths!

Engagement at Work

• I know what’s expected • My opinions seem to count • I am talked to about my progress • The mission makes me feel important • Supervisor cares about me

A Culture of “Wellness” “A wellness culture features norms that make it easier for people to maintain healthy lifestyles… Norms are social expectations for behavior and beliefs – the way we do things around here.”

Program to participant needs: Re-examining motives

Whose program is it―yours, ours or theirs? • Who built it? Why? • What role did employees play?

Programming to, not at

• What makes them tick? • What are barriers? • Seek out their goals

Understanding the culture

• Leadership/ management • Unwritten rules • Expectations • Environment

Make the right choice, the easy choice • Fresh Fruit Fridays • Marked paths • Water coolers • Standing Work stations • Vending – choose right look right

Programming to the unreachable

• Program to participant needs • Program messages to reach each stage • Program plans designed to engage • Program outcomes to show change

Messages to reach each stage Weaving together theory and practice to reach all

• Stages of Readiness • Learning preferences • Intrinsic motivation

Prochaska’s Stages of Change

• Pre-contemplation/Contemplation • Preparation • Action • Maintenance/Relapse

If we only offer programs to those in the action phase, we not only miss large portions of the population, we also ignore employees that have made change. Adult Learning―adults want self-management and control

• Adults learn at different rates and in different ways • Adults want efficient use of their time • Adults want to be active participants in learning • Adults operate from problem solving mode and want practical solutions

Health Belief Model

• Aware and understand the risk/s • Care about consequences • Understand benefits • Know the barriers

Stages of Change to Reach Everyone

• Lay out annual calendar • Cross check against stages • Brainstorm holes • Have you reached past the action/maintenance people? • Are you making them come to you?

Did you Choose the Right Fit? • Outcomes driven • 5 Pillars of Wellbeing • Zero trends • Online

Creating Intrinsic Motivation

• Goals and rewards that are meaningful • Learning/activities that are important • Engage people in the change process • Customize programs based on where individuals are at • Change requires leaders to recognize, encourage and deepen their team’s insights

Program Ideas

● Too Tired to Move ● Personal Transformation ● Get in Shape to Hunt ● Stand up for Health ● Retire on $10 a day

● Park and Walk ● Parenting: Where’s the instruction manual? ● Balancing Life’s Stressors ● Shout outs ● Venison cook-off

Evaluation: Asking the right questions, measuring both objective and subjective

• Participation • Satisfaction • Self efficacy • Barriers • Testimonials • How can we support you?

Reaching the unreachable What more have you done?

• Follow-up • Expand your menu • Address barriers • Support confidence

Celebrating Success: Do they know what has been achieved? Leadership Management Wellness committee Employees

Take Away Points:

• Program to your people • Specific communication to those you are trying to reach (pre-contemplator/contemplator/preparers) • Spiral your messaging • Shift paradigms from wellness to wellbeing to engage the unreachable

Cross-Train Your Brain Terry Eckmann, Ph.D. - Minot State University

[email protected]

1. Physiological Principles of Training Applied to the Brain a. Principle of Individuality b. Principle of Specificity c. Principle of Reversibility d. Principle of Progressive Overload

2. Lifestyle Choices and the Brain (Small, 2006; Nussbaum, 2006; Ratey, 2008 a. Physical Activity b. Mental Stimulation c. Socialization d. Healthy Diet e. Stress Management f. Spirituality g. Medical, Dietary and Lifestyle Choices Promote Health Brain Aging

3. Aerobic Exercise & Brain a. Stimulates BDNF (Adlard, Perreau, & Cotman, 2005) b. Boosts Vascular Endothelial Growth Factor & Insulin-Like Growth

Factor (Van Pragg, 2009 & Carro, et.al., 2000) c. Neurogenesis in the Hippocampus (Ahlskok, et.al., 2011; Erickson, et

al., 2011; Erickson, et al., 2011; Barber, Clegg, & Young, 2012) d. Oxygen & Glucose to the Brain Faster (Joyner & Green, 2009) e. Improves Mood (Walter, et al., 2013) f. Elevates Stress Threshold g. Balances Brain chemicals, hormones & system functions h. Prepares the Brain for Optimal Learning (Chang, et.al., 2012, Jensen,

1998)) i. Decreases amyloid-B plaque in prefrontal cortex and enhanced rate of

learning (Adlard, et.al, 2005) j. Reduces chance of late-life cognitive impairment (Middleton, et al. 2010) k. Zumba vs. Yoga in Women age 65 to 91 l. Les Mills BodyPump vs Yoga in men/women age 50 to 70 m. Wellbeats Transition Live vs. Virtual in women age 45 to 65 n. In a 6 month aerobic walking vs. stretching program walkers showed

significant improvement over those who stretched (Oken, et al, 1999)

4. Yoga & the Brain a. Astanga yoga decreased diastolic blood pressure & reduced stress

(Cowen & Adams, 2004) b. Yoga enhanced mindfulness, reduced job stress, decreased anxiety,

lowered cortisol levels, improved sleep, and reduced intensity and frequency of headaches (Field, 2011)


c. Yoga can lead to significant reduction in perceived levels of anxiety in women suffering from anxiety disorders (Javnbacht, Kenari, Ghasemi, 2009)

d. Research review supports the benefit of yoga in treatment of anxiety and depressive disorders (da Silva. Ravindran, Ravindran, 2009)

e. Yoga is a potentially beneficial intervention for depression (Pilkington, 2005)

f. Health Benefits of Yoga and Exercise: A Review of Comparison Studies. (Ross & Thomas, 2010)

g. Yoga and relaxation provide a comparable improvement in stress, anxiety and health status (Smith, 2007)

h. GABA levels increased 27% after a yoga session and no change in GABA occurred after reading session (Streeter, 2007)

i. Yoga group reported greater improvement in mood and anxiety and GABA levels than a walking group (Streeter, 2010)

5. Meditation & the Brain (Suzuki, 2015) a. Less Activation in the frontal lobe of meditators performing a task of

selective attention b. People who meditate significantly improved attention and visual

discrimination c. Different kinds of meditation result in increases in cortical volume,

particularly in the right angular gyrus & parahippocampal gyrus; d. Aerobic exercise and medication have similar effects on mood and

well-being in subjects with social anxiety disorder 6. Aquatic Exercise & the Brain

a. A 10-Week aquatic program let to greater improvement in task conditions that executive and attention control (Hawkins, et al., 1992)

7. Dance & the Brain a. Dance helps the older brain form new interconnections and to work

faster, it also increases blood supply to the brain and temporal and prefrontal brain activity responsible for memory improvement (Alpert, P. 2011)

b. Ballet participants improved postural alignment, balance, stability & motivation to exercise (Houston & McGill, 2012)

c. Dance decreased depression and increased vitality more than listening to music ( Koch, et al, 2007)

8. Resistance Training & the Brain a. Participants in a combined aerobic and strength training program

improved cognition to a reliably greater degree than those in aerobic training alone (Colcombe, S. & Kramer, A., 2003)

9. Sport, Leisure Time Activities & the Brain a. Leisure time activities and healthy dietary choice are associated with

slower memory and visual search speed design over 20 years (Cadar, D. et. al., 2012)

b. Exercise and Sport activities approximately 7 hours a week results in higher grades, better personal relations, and less drug use (Field, et al 2001; Martin, 2010)

c. Leisure Activities and the Risk of Dementia in the Elderly. (Verghese, 2003)

d. Brain Boost: Sport & Physical Activity Enhance Children’s Learning. Martin, K,

10. Diet & the Brain a. Daily consumption of fruits and vegetables associated with 28%

decrease in risk of dementia; Weekly consumption of fish associated with a 35% reduction in Alzheimer’s (Barberger-Gateau, P. et.al., 2007)

11. Best exercise program to Maximize Brain Health a. Cross-train with Aerobic Exercise, Resistance Training, Flexibility

Training, Dance, Yoga, Tai Chi and Brain Safe Leisure Time activities 12. Minute Mover & Minute Minder Activities

ACSM’s Health and Fitness Summit

An Integrated Approach for Working with Health Challenged Clients

Brad A. Roy, Ph.D., FACSM

I. Introduction / Background a. Medically Integrated Fitness Centers b. The Summit Medical Fitness Center

II. The Chronic Health Challenge a. How did we get here?

III. Where are we going? a. Population Health

i. Zero Trends ii. Care Coordination

iii. What’s Missing? b. Lifestyle Medicine

i. Anthropogens ii. Data Driven

iii. Health Coaching IV. The Summit’s Journey to Wellness Program

a. Background b. The Approach c. Staffing – Education and Credentials d. Outcomes

V. Looking Beyond a. Patient / Client Engagement b. Exercise is Medicine / Lifestyle Medicine c. Technology d. Key Characteristics for Health and Fitness Professionals working in Healthcare

Laura J. Kruskall, PhD, RDN, CSSD, LD, FACSM, FAND, ACSM EP-C Nutrition in Inflammation and Immunity

I. Physiology of Inflammation A. Acute vs Chronic Inflammation B. Modern Diet & Inflammation

1. Obesity 2. Autoimmune Diseases

II. Vitamin D A. Functions of Vitamin D Promotes calcium absorption in the gut Helps with cell growth Aids in immune function May reduce inflammation

B. Vitamin D Status Note: may vary by testing laboratory < 10 ng/ml deficient < 20 ng/ml insufficient > 30 ng/ml adequate or sufficient 150-200 ng/ml may be safe. More research is needed.

C. Vitamin D Recommendations Recommended Dietary Allowance (RDA) 200 IU (5 µg), ages ≤ 50 400 IU (10 µg), ages 51-70 600 IU (15 µg), ages ˃70

National Osteoporosis Foundation 400-800 IU (10-20 µg), ages ˂ 50 800-1000 IU (20-25 µg), ages ˃ 50

Upper Limit Current UL = 50 µg (2000 IU) per day

D. Food Sources Milk, salmon, mackerel, sardines, cod liver oil, whole eggs, fortified cereals Fatty fish: 1 tbsp cod liver oil = 1,360 IU 3 oz swordfish = 566 IU 3 oz sockeye salmon = 447 IU 3 oz mackerel = 180 IU 3 oz tuna fish 154 IU

Milk (nonfat, reduced fat, whole): 8 oz = 115-124 IU Animal products: 3 ounces liver, egg yolks, beef = 42 IU Ready to eat fortified cereals: ¾ - 1 cup = 40 IU 1 oz Swiss cheese = 6 IU


III. Omega-3 Fatty Acids A. Types of Omega-3 (Essential in the diet body cannot make them) Alpha-linolenic acid (ALA). Plant source; Shortest omega-3 FA; Sources: soybean oil,

walnuts, canola oil, flaxseed Eicosapentaenoic acid (EPA). Sources: certain algae and the fish that eat it Docosahexaenoic acid (DHA). Longest omega-3 FA; Sources: certain algae and the fish

that eat it

B. Role of Omega-3 in Inflammation C. Omega-3 Recommendations

DRIs 1.6 g/d Men; 1.2 g/d women 0.6-1.2% of total energy NOTE: this is total omega-3 not EPA & DHA

General Recommendation from the Literature ~1000 mg (1 g) per day from EPA & DHA

American Heart Association: Adults without CHD: fatty fish 2x/week + oils rich in ALA Adults with CHD: 1 g/d EPA + DHA Adults with elevated triglycerides: 2-4 g/d EPA + DHA under physician’s care

Therapeutic Dose = 3.4 g/day or more

D. Issues with Omega-3 Supplements 1. No established method for measuring Omega-3 Status 2. Must look for DHA & EPA on the label, not just total Omega-3 or “fish oil” 3. Be wary of “double strength” or added oils like omega-6 4. Fish oil is not vegan vegan clients need to purchase the algae form ($$$$) 5. Mercury is a concern- use a reputable brand that claims mercury free 6. Look for NSF or USP seals

E. Food Sources Food Total omega-3 (mg) EPA (mg) DHA (mg) Salmon 2131 733 938 Canned tuna 808 198 535 Rainbow trout 690 142 357 Halibut 444 60 248 Egg 20 n-3 Enhanced Eggs

150

Enhanced Spreads (1T)

30

Soy Milk 30


IV. Healthy fats Pro-Inflammatory Fats: Trans, saturated Sunflower oil Corn oil Safflower oil Soybean oil Cottonseed oil Vegetable oil Animal meat (arachidonic acid)

Anti-Inflammatory Fats: Mono unsaturated Omega-3 Flax seed Canola oil Walnuts Pumpkin seeds Leafy greens Fatty fish Omega-3 enhanced products Borage oil Evening primrose oil Algae

Controversy with full fat dairy, butter, and egg yolks

V. Quality Carbohydrates Emphasize: fruits, vegetables, whole grains, legumes Limit: refined grains, added sugars It appears that EXCESS consumption of fructose and glucose (table sugar and high-fructose

corn syrup) seems to be pro-inflammatory NOTE: excess consumption does not come from eating fruit. It is the processed foods and

beverages that are a problem

VI. Prebiotics and Probiotics Gut microflora is essential for the optimal function of the immune system Keeping this in balance may help Probiotics: live microorganisms, which when administered in adequate amount, confer a

health benefit on the host Prebiotic: ingredient that targets the microbiota already present within the gut, acting as a

‘food’ for the target microbes Cons:

• May negatively interact with gut & metabolic function • Live microorganisms can move to another body part like any other organism • Not regulated by the FDA

Food sources • Probiotics: yogurt, kefir, naturally fermented sauerkraut, kimchi • Prebiotics: bananas, oatmeal, beans, asparagus (other fiber rich plant foods may also

help)

Make sure your physician knows if you are taking a supplemental form as these are live organisms

Keeping It Positive Social Media & Body Image

Presented by Amanda Vogel, MA, for #ACSMSummit16 @amandavogel (Twitter) ~ @amandavogelfitness (Instagram)

FitnessTestDrive.com (Blog) ~ [email protected] ______________________________________________________________________________

Body Image & Social Media: What Are People Posting?

• Body-‐conscious selfies

• Before-‐and-‐after comparisons

• Motivational memes

• #fitspo #instafit #noexcuses

Filtered Reality

• Traditional media versus social media

• Identity management

• Positive/negative perceptions toward the poster on social media (study: Oregon

State University)

• Men’s body image and fitspo

Research on Body Image & Social Media

• Social Comparison Theory, self-‐comparison

• Women’s Facebook usage and body dissatisfaction/body image concerns

• The link between social media usage and disordered eating

• Survey: ____ % of respondents reported that seeing photos of themselves or

others on Facebook made them feel more conscious of their bodies and weight

(Center for Eating Disorders at Sheppard Pratt)

Social Media Content That Promotes Positive Body Image

• Inspiring versus shaming > INTENTION AND PERCEPTIONS

• Your own values, philosophy and leadership role on body image

• Hashtag streams you feel comfortable associating yourself with

• Your target market’s values, perceptions and vulnerabilities

Positive Body Image Posting Guide (Excerpt from Vogel, A. 2015. Social media and body image: A complicated relationship, IDEA Fitness Journal, 12 (1), 38-‐44.)

Ask yourself these questions before hitting tweet, share, pin it or post.

• Why am I posting this message, meme or photo? Is this post for my own

gratification or to inspire, help and connect with my network?

• Will the majority of my followers and/or target audience perceive this post to be

positive or negative? Motivating or discouraging? Neutral or sexualized? What’s

the intention?

• Would a person who’s new to fitness and/or concerned about body image feel

intimidated, dissatisfied or ashamed after viewing/reading this post?

• Does this post degrade or make fun of others, particularly people who don’t

exercise and/or are overweight?

• Does this post represent my philosophy on fitness? Does it reflect the kind of

fitness professional I want to be?

>> Email me for a list of research references discussed in this session.<<

Amanda Vogel, MA human kinetics Certified Hootsuite Professional & Ambassador

Fitness Technology Spokesperson for IDEA Email: [email protected] Web: www.ActiveVoice.ca

Blog: www.FitnessTestDrive.com FB: Facebook.com/FitnessWriter

Pinterest: Pinterest.com/FitnessWriter TW: @amandavogel

IG: @amandavogelfitness

“Nine Months to Shape Our Future”

Katie Smith, PhD, RDN, LD, ACSM Certified Exercise Physiologist Excessive gestational weight gain increases maternal and fetal risk of future chronic disease. This session will explore the current gestational weight gain recommendations and the current research to understand how we can shape the future health of generations to come.

Objectives: • Identify the recommendations for healthy weight gain during pregnancy • Define risks associated with excessive gestational weight gain • Recognize which clients are at highest risk of gaining excessively • Discover methods that exercise professionals may use to increase adoption of healthy

lifestyles during pregnancy • Discuss current guidelines for exercise during pregnancy

Description: Establishing healthy lifestyles during pregnancy positively influences the maternal and fetal environments and creates biological and behavioral tendencies that increase likelihood of reducing chronic disease later in life. This session will help exercise professionals recognize what we can do to optimize the health of our future generations.

Needs statement: Research supports as many as 70% of pregnant women gain weight in excess of the Institute of Medicine recommendations, increasing the likelihood of maternal gestational diabetes, hypertensive disorders, postpartum weight retention, obesity, and fetal chronic disease. Society predisposes women to adopt unhealthy lifestyles during pregnancy by encouraging them to rest and “eat for two”. This session will help exercise professionals recognize their role in this phase of the life cycle.

Three Practical Take-Away Points for Attendees:

1) Intervention early in pregnancy is crucial to success; prevention of excessive gestational weight gain prior to 20 weeks gestation significantly decreases the likelihood a woman will exceed weight gain recommendations.

2) Charting gestational weight gain against the Institute of Medicine recommendations is an inexpensive and effective method of monitoring weight gain during pregnancy.

3) An interdisciplinary healthcare approach is necessary to address the role of exercise and nutrition in preventing excessive gestational weight gain.

Past, Present, and Future Applications of Kettlebell Training! ACSM’s 20th Health & Fitness Summit & Expo

Nick Beltz, MS, ACSM-RCEP, CSCS University of New Mexico 3 Major ‘Takeaways’: 1) Kettlebell training has been used as an effective training tool to promote improvements in muscular strength and power for centuries, 2) The most recent research demonstrates their potential to elicit benefits in muscular strength, power, aerobic and functional capacity, as well as safely managing orthopedic injuries, 3) Foundational kettlebell movements can be used in conjunction with other resistance design principles to implement effective total body resistance training programs.

I. What is a kettlebell?

a. Cast iron or steel “cannonball” with thick handle and flat base

b. Originally appeared in the Russian dictionary in early 1700s as “girya”

c. Evolved through many uses until it was popularized as a foundational Russian strength

training tool in the early 1900s, Dr. Vladislav Krayesvky

d. 1998: “Modern King of Kettlebells” Pavel Tsatouline

e. 2001: “The Russian Kettlebell Challenge”

f. 2006: “Enter the Kettlebell! Strength Secret of the Soviet Supermen”

g. 2011: Literature review resulted in ~5 published peer reviewed research manuscripts

h. 2016: 30+ peer reviewed research manuscripts!

II. Fundamental Kettlebell Movements

a. Swing: Two or One handed, swinging the kettlebell between your legs, and using your hips to

propel the kettlebell to chest level

b. Clean and Press: One handed, swing the kettlebell between the legs just as in the swing, but

bring it up more vertically to a racking position, gather, press vertically

c. Snatch: Similar to a swing until a high pull and punch through, locking out at the top

d. Turkish Get Up: Starting on the back, kettlebell pressed and extended upwards. Slowly stand

up while keeping the kettlebell straight and vertical, then reverse

III. Biomechanical Demand of the Kettlebell

a. During eccentric phase of the swing, the success of the swing depends on the active flexing of

the hip and governing hamstring to break the kettlebell, immediately followed by ballistic

concentric triple extension of the hip, knee, ankle to propel the kettlebell in an upward arc

b. The impulse (magnitude and rate of applied force) of 32kg kettlebell is greater than VJ or BS

c. Snatch emphasizes greater vertical rather than horizontal displacement

d. Swing similar horizontal impulse ratio similar to that observed in sprinting mechanics

e. Snatch may be more appropriate for activities involving vertical movements

f. Novice users have tendency to under-extend the hips, important for instruction

g. Many fundamental movements elicit shear forces rather than compressive forces on the spine

IV. Muscular Fitness

a. Intensity during fundamental movements high enough to elicit positive changes in strength

b. Acute bout stimulates hormone response (C,T,GH) associated with strength and hypertrophy

c. Similar improvements as traditional power training (jump squats) in 1RM squat and vertical

jump height

d. May provide a safe and effective alternative to develop muscular power

V. Cardiorespiratory Fitness

a. Traditional protocol produce aerobic intensity ~80-90% HRmax and ~50-65%VO2max

i. Intensity high enough to produce CR benefits

b. Improvements in aerobic fitness (↑6-14%)

VI. Rehabilitation

a. Excellent for many phases of rehabilitation and for individuals in need of power development

with hip strength imbalances

b. Lower loads can reduce potential damage to newly forming fiber and vessel networks

c. Less restriction in movement planes compared to many traditional equipment

d. Potential to isolate hamstring development to address knee imbalances

e. Huge dependency on core stabilizers during exercise promotes positive changes in postural

control, and neck/back pain

VII. Suggestions for Future Applications

a. Movement specific training in sport

b. Clinical Populations

i. Management to decelerate sarcopenia

ii. CVD risk factor modification

iii. Glycemic control in T2DM

iv. Maintenance of QOL via performance of ADLs

VIII. Recommendations for Kettlebell Training Design:

a. Master the fundamentals with minimal equipment

b. Concentrate on multi-joint, multi-plane movements rather than muscle group philosophy

c. Manipulate design variables based on certain physiological principles

i. Eccentric training

ii. Dynamic isometrics

iii. Work : Rest

iv. Power and Explosion

v. Drop Sets and Super Sets

2016 ACSM Health and Fitness Summit Michael J. Spezzano

Lecture Outline ACSM Health and Fitness Summit 2016

“The 5 Point Plan for Fitness Management Excellence”

Michael J. Spezzano

Healthy Living Consultant [email protected]

Overview This session will present a comprehensive five-point blueprint for managing, evaluating, and improving a club or organization health/fitness operation. It will feature a take-home template for leaders and managers of health and fitness departments in all types of centers, clubs, and other organizations. The improvement plan is focused on five key areas for management success - staff, programs, facilities, equipment, and systems - that represent the primary skill sets needed to succeed in health and fitness management. Best practices will be presented for these five areas, making this session a mini-management course for directors striving for excellence in their organizations. Objectives 1. Understand the process of evaluating key areas for management success 2. Learn new tools to improve staff, program and facility growth and quality 3. Learn ways to assess and modify key management areas based on member needs Managing a health/fitness center requires operating systems to ensure that the club runs seamlessly from member services to programming and equipment. This session will share practical tools to help you discover how to run an efficient and successful health/fitness facility by sharpening your skills and learning new management tools and an action plan to act as a roadmap for the change. Outline

I. Introduction 1. Overview 2. The Health Fitness Manager 3. Management Roles and Responsibilities

II. Management Requirements 1. Core Competencies 4. Key Performance Areas 5. The 5 Point Management Plan 6. Develop a Department Audit Tool


III. Staff 1. Hiring 2. Supervision and evaluation 3. Training:

a. Certifications b. In-house c. CECs

IV. Programs

1. Core Programs a. Group b. Personal Training c. Individual Exercise

2. Programs for Beginning Exercisers 3. Medical Fitness

a. Programs b. Referrals c. Partnerships

4. Program Innovation 5. Special Events

V. Facilities

1. Standards 2. Cleaning 3. Maintenance

VI. Equipment

1. Vendor selection 2. Preventive maintenance 3. Service 4. Replacement

VII. Systems

1. Risk management 2. Finance 3. Supervision 4. Service 5. Marketing 6. Standards and Audits 7. Policies and Procedures


Resources 1. Fitness Management, 3rd edition, Stephen Tharrett and James Peterson, 2012, Healthy

Learning Publishers 2. Health Fitness Management, 2nd edition, Mike Bates, 2008, Human Kinetics Publishers

3. The DOs & DON’Ts for Fitness Center Operations, John Comereski, 2013, Healthy Learning

Publishers

4. ACSM’s Health/Fitness Facility Standards and Guidelines, 4th ed., American College of Sports Medicine, 2012, www.acsm.org, http://www.humankinetics.com/products/all-products/ACSMs-HealthFitness-Facility-Standards-and-Guidelines-4th-Edition

5. MFA’s Standards and Guidelines for Medical Fitness Center Facilities, Medical Fitness

Association, 2013, https://medicalfitness.site-ym.com/store/view_product.asp?id=1614090

6. Risk Management for Health/Fitness Professionals, Joann Eickhoff-Shemek, David Herbert, Daniel Connaughton, 2009, Lippincott, Williams, & Wilkins

Industry Trend Reports 1. IHRSA 2015 Profiles of Success: The Annual Industry Data Survey of the Health and Fitness

Club Industry, 2015, International Health, Racquet & Sportsclub Association Seaport Center, Boston

2. 2015 International Fitness Trend Industry Report: What's All the Rage? American Council on

Exercise, International Health, Racquet, and Sportsclub Association, and ClubIntel, 2015. Boston and San Diego

3. 2015 IHRSA Health Club Consumer Trends Report. International Health, Racquet, and

Sportsclub Association. Boston.

4. Thompson, Walter R. Ph.D. Worldwide Survey of Fitness Trends for 2016: 10th Anniversary Edition. ACSM'S Health & Fitness Journal: November/December 2015 - Volume 19 - Issue 6 - p 9–18

5. 2015 IDEA Fitness Programs and Equipment Survey. IDEA Health and Fitness Association.

2015. San Diego. 6. ISPA Industry Study Consumer Trends Report. International SPA Association. 2015.

Lexington, KY.

http://www.acsm.org/

http://www.humankinetics.com/products/all-products/ACSMs-HealthFitness-Facility-Standards-and-Guidelines-4th-Edition

http://www.humankinetics.com/products/all-products/ACSMs-HealthFitness-Facility-Standards-and-Guidelines-4th-Edition

https://medicalfitness.site-ym.com/store/view_product.asp?id=1614090

BOSU® Total Body Blast

1. To BOSU or not to BOSU: That is the question!

A. Who needs it?

Everyone

B. Who does it?

People who are good at it

People that are convinced it will help them improve

C. How can we do more?

Get smarter about programming

2. For Best Results

A. Drills vs. Choreography

B. Built in Breaks vs. Take it if you need it

C. Repetition vs. Variety

D. Coach vs. Demo (Balance Challenge Variables)

3. The Building Blocks of BOSU Programming

A. Shorter chunks of time with the BOSU® Balance Trainer

10 min

15 min

20 min

B. Choose a Focus

Singular or multiple

Choose: cardio, strength, flexibility, core

C. Initial Drill Selection& Sequencing

10 min = 2 drills x 3



D. Refine & Determine Variations for Drills (≈1.5 min per drill)

Practice it – set the intention and groundwork for the drill

Perfect it – provide on the spot progressions & regressions

Finish It – focus on effort before leaving the drill for now

Warm Up Foot Placement Acclimation (weight, ankle noise)

Center of Gravity Acclimation (slight bend in the knees, gently shift forward and back and then out and in with the weight in your feet)

March / Jog on Top

Stop on top & Squat (tempo, hold, tracking)

BLOCK 1: Cardio, Strength + Core Key: PSU: Platform Side Up DSU: Dome Side Up

March / Jog on Top Push Ups Planks

Round 1 Up / Down

((walkjogjump) PSU – Push Up + Floor Squat

(Ladder: 12345)

PSU Plank

(with tilt & rock)

Round 2 Up / Down + Out / In

(walkjogjump)

DSU – Knee Push Up + Stand

(Ladder: 12345)

DSU Plank

(knee pull + twist)

Round 3 Up / Straddle / Exit

(walkjogjump)

DSU – Biased Push Up

(add jump squat to top)

DSU Plank (toes on top)

(walkjump upjack)

Stretch: Seated Forward Fold Bent Knee Twist Turtle Standing Wide Leg Forward Bend and Roll Up

BLOCK 2: Cardio, Strength + Core

Alternating Knee Up Lunges Crunch

Round 1 Alternating Knee Leaps Stationary Lunge w/ Rotation Crunch + Oblique Crunch

Round 2 Alternating Knee Power Reverse Lunge w/ Rotation Crunch + Oblique w/ Knee Lift

Round 3 Alternating Knee Touch Back Swivel Lunge Deadbug + Double Crunch

Stretch: Supine Surrender Side Lying Stretch Quad IT Band Stretch Seated Inhale/Exhale

BLOCK 3: Cardio, Strength + Core

Over the Top Lateral Squat Back Extension

Round 1 OTT + Back

(speed & low / propulsion)

Lateral Squat (from top)

Right 3 Pulses, Center, Left 3 Pulses Back Extension

Round 2 Leap + Over the Top Lateral Squat Across

(with weight shift)

Sky Diver

(X,I, Reverse)

Round 3 Icky Shuffle Over Lateral Squat + Lunge Back

(R, jump squat center, L) Swim + Prone Heel Touch

Stretch: Runner’s Lunge (side of dome) Down/Up Dog other side Runner’s Lunge Walk In & Roll Up

www.BOSU.com

ACSM’s 20th Health & Fitness Summit Orlando, FL March 29-April 1, 2016

1

Cardio Cuts & Core Irene Lewis-McCormick, M.S., C.S.C.S.

[email protected]

Experience a 3, 2, 1 punch using this easy to follow HIIT protocol for muscular strength, endurance and cardio. Perform “hard” activity for 40 seconds followed by a “harder” interval for 30 seconds then the “hardest” microburst of intensity for 20 seconds. Learn progressions, and options that will appeal to all levels of fitness. Pre-formatted music makes this class extremely reproducible. Format Adapted from Tabata Bootcamp Instructor Training; Mindy Mylrea, www.tabatabootcamp.com.

• Benefits of HIIT o Microburst training o EPOC

After burn can last 24-36 hours post exercise

• 2:1 Ratio Training o Work 2x longer than recovery o Build in on ramps for more or less intensity o In-Workout recovery o Between workout recovery

• Exercise Selection Options

o Cardio Planes of Motion

o Muscular Endurance Tubing, Body Weight

o Muscular Strength Hand weights, KB

o ROM/Flexibility o Partner work/Bootcamp Style o Standing or Floor-based core training

• Music

o Tabata Bootcamp from Dynamix Music www.dynamicmusic.com Downloads or CD Use Code LEWTB14 for a 10% discount online

Take Away Points

• Quick, microburst formats can meet fitness needs in short time intervals with significant variety in training.

• Recovery ratios are the key to creating EPOC • This program is inclusive with many options for a variety of fitness levels

Marc Lebert– Lebert Fitness | www.LebertFitness.com | facebook/lebertfitness | twitter/lebertfitness | pinterest/lebertfitness | youtube/mlebert

LTS™ - Athletic Training for Everyone By Marc Lebert - If you want to look like an athlete, it helps to train like one. Most people want to look athletic (and lose weight) and then proceed to train on the elliptical! This sports training workshop gives you a complete athletic workout - from unique warm-up drills and functional movements to advanced bodyweight training with the amazing portable Lebert EQualizer, Lebert BUDDY SYSTEM and Lebert SRT Barbell. A super-fun session that’s adaptable to make anyone feel and look like an athlete.

WARM UP

Part 1

Jog around gym/room- have to do the “road work”. Nice and easy and give people a chance to chat and

catch up for a minute. Add side-steps, leg-drags, Karaoke, Skipping, Bowling (touch floor both sides),

Volleyball spikes (both arms), stop/squat/pop, etc. Mix it up!

Part 2

Nervous system warm-up- get a partner and face each other- one person in athletic stance and solid like a

rock- the other partner clapping both hands (evenly) as FAST as they can- for one minute!

Next one- face each other- touch toes, knees, hips, shoulders and jump up for a high five (1min). Then

one person leads and does those in any order- the other has to react/mirror them.

Last one- squat low facing your partner- hands open and in front of you- stay on toes and try to push the

other person over. Feet can’t move or you lose!

Part 3

Warm-up #2 Equalizer® Mobility

1. Agility Ladder- side shuffle

2. Hip Opener

3. Agility Ladder- burpees

4. Over-Unders (only slightly over- definitely under!)

5. Agility Ladder- side shuffle with backpedaling over the foam grip

Part 4

Warm-up #3 BUDDY SYSTEM™ Mobility

6. Light Uni-lateral Row (Thoracic Mobility)- athletic stance, lower body quiet, long range of motion

with hands right to rib cage

7. Light Running Drills

8. Light Low Low low tug-of-war (controlled)

LEBERT EQualizer® EXERCISES

Vertical Rows Cueing hips up and head back starting position. Basic row with many modifications to suit any level

Incline Push ups Foot positioning and variations

Dips Leg Assisted

http://www.lebertfitness.com/


Leg Raise and “Running Person” Progressions

Kneeling Tricep Extensions Personal fave!

Hip Raise Working with the posterior chain

Split Squats Balance, strength and stretch all in one

Cardio Ideas Using the EQualizers for various cardio movements

Stretch Hip/glute, hamstring, adductor, quads

LEBERT EQualizer® Programming The EQualizer® was originally designed to perform a body weight pull up but we will cover much more with this programming, including agility ladder drills, body weight training and boot camp conditioning.

LEBERT BUDDY SYSTEM™ EXERCISES

Unilateral Rows Wide base of support, head and chest up, long smooth pulling

Bilateral Rows You can really “feel” if your client is working here!

Swimming Feet close and upper body slightly hinged forward. Pull behind you

Cross-Bow Rear delts, chest fly, and core all in one exercise!

Legs Why the Buddy System makes for a great assist when squatting



LEBERT BUDDY SYSTEM™ Programming Once you try the BUDDY SYSTEM™ you won’t want to put it down! And for 10 minutes we won’t!

highly efficient sets of muscle endurance

multi-planar/multi-directional

manual resistance

resisted running

LEBERT SRT Barbell™ Exercises

Bicep series with inward/outward squeeze - incorporating overhead press and lunges



Overhead press/burpee combination

Cross chop pattern and lower body to failure



Back - lat pull (rhythm changes ) with upright row and Lateral lunges

Tricep presses and extensions with gradual progression and HIIT

Chest - push-ups


Nutrition in the News Christopher R. Mohr

1. How Do We Define Nutrition?

a. Through food? b. Ingredients?

2. What Diet is Best?

a. Low carbohydrate b. Low fat c. High protein d. Paleo

3. Coconut: The good, the bad, the ugly

a. Is there research? b. Is oil a healthy saturated fat?

4. Fasting – Scientific Support or Passing Trend?

5. Protein

a. Are we eating enough? b. How is your protein timing?

6. What is the research on sugar?

7. What is the research on saturated fat?

8. Simple strategies for healthy eating patterns for all

2016 ACSM Health and Fitness Summit Running Gait – Injury, Intervention, and Implications

Session Outline ACSM Health and Fitness Summit

March 29 – April 1, 2016

Running Gait – Injury, Intervention, and Implications March 30, 12:00-1:00pm March 31, 9:30-10:30am

Roberto Ruiz, MA, ACSM EP-C, CSCS Exercise Physiologist/Health Science Specialist Pentagon DiLorenzo TRICARE Health Clinic Fit To Win/Wellness [email protected] Summary The popularity of running has never been so high with a seemingly endless number of events such as 5k, 10k, 10-milers, half and full marathons, ultra running, and obstacle running events being offered throughout the year. Reasons for running are numerous. Many run for health to improve cardiovascular fitness and decrease their risk of disease, yet others use running as part of a weight loss/management program. Some run as their job requires a minimum fitness standard (military, first responders). Running is an innate movement begun early in life that is not typically taught or coached. Running injuries will occur to most runners and many strategies can help reduce the risk of injury. One strategy is to modify running biomechanics. This session will give an overview at how one’s running gait plays a role to help keep a runner moving and injury free. Session Format

I. Introduction a. Objectives b. Takeaways c. Injuries

II. Running Biomechanics and Anatomy a. Phases of Gait b. Kinematics c. Kinetics

III. Gait Analysis a. Efficacy of Gait Analysis b. Movement Red Flags c. Running Shoes and Implications d. Gait Analysis Tools

IV. Gait Interventions a. Foot Landing Pattern b. Stride Frequency c. Posture


2016 ACSM Health and Fitness Summit Running Gait – Injury, Intervention, and Implications

d. Caution & Contraindications

V. Questions Key Take-Away Points

• Understand basic running biomechanics has implications to injury due to abnormal joint movement patterns and how running shoes are implicated to these injuries.

• Understand how forces influence injuries and provide the ability to identify gait or posture patterns that may lead towards injury.

• Be able to apply simple evidence based techniques for gait intervention to help mitigate the risk of a running injury safely as necessary.

Selected References

• Agresta C, et al. Gait Retraining for injured and healthy runners using augmented feedback: A systematic Literature Review. J Ortho & Sports Phys. Ther (2015) 576-584.

• Dicharry J. “Kinematics and Kinetics of Gait: From Lab to Clinic.” Clin Sports Med 29 (2010) 347-364.

• Napier C, et al. Gait Modifications to change lower extremity gait biomechanics in runners: a systematic review. Br J Sports Med (2015) 1-8.

• Nicola T. et al. “The Anatomy and Biomechanics of Running”. Clin Sports Med 31 (2012) 187-201.

• Novacheck T. “The Biomechanics of Running.” Gait and Posture 7 (1998) 77-95. • Saragiotto B, et al. What are the main risk factors for running-related injuries? Sports

Med (2014) 44(8):1153-63. • Vincent HK, et al. Setting the standards for medically-based Running analysis. Current

Sports Medicine Reports (2014) 275-283. • Zadpoor A, et al. The relationship between lower-extremity stress fractures and the

ground reaction force: A systematic review. Clinical Biomechanics 26 (2011) 23-28. Selected Books

• Dicharry J. Anatomy for Runners: Unlocking Your Athletic Potential for Health, Speed, and Injury Prevention. Skyhorse Publishing, 2012.

• Ferber R, et al. Running Mechanics and Gait Analysis: Enhancing Performance and Injury Prevention. Human Kinetics, 2014.

• Wilder R. et al. Running Medicine, 2nd Edition. Healthy Learning, 2014. Useful Websites

• http://armymedicine.mil/Pages/Minimalist-Running-Shoes.aspx • www.efficientrunning.net • www.therunningclinic.ca • www.sportsscientists.com • http://thegaitguys.tumblr.com/ • http://runninginjuryclinic.com

http://www.therunningclinic.ca/

http://thegaitguys.tumblr.com/

Triple Action Abs Abbie Appel ACSM Health and Fitness Summit and Expo 2016 Orlando

www.abbieappel.com [email protected] [email protected] twitter.com/abbieappel

Small Ball - Make movements more effective 1. Bird Dog with ball or water ball on sacrum 2. Elbow Plank - ball under belly Lift and lower knees Extend one leg (extend hip) Saw - Rock forward and back (sagittal) 3. Side Plank - ball under waist Lift waist Lift and Lower Leg 4. Side Lateral Spinal Flexion over Ball 5. Seated Spine Twist 6. Ab Curl - Crunch 7. Criss Cross - elbows and knees together - Ball resting on shins 8. Half Roll Back w/o twist 9. Leg Pull Front 10. Swan Bodyweight 1. Bird Dog Stability Oppositional Arms/Legs Flexion/Extension 2. Prone Plank - No Spinal Movement Lift and Lower Arms/Legs Saw 3. Side Plank Lift and Lower Waist Lift and Lower Top Leg 4. Side Bend twist to Teaser (Seated V) 5. Ab Curl 6. Criss Cross Stability Ball - Unstable surface 1. Kneeling on Ball 2. Bird Dog Ball under One Hand Ball under One Foot 3. Prone Elbow Plank 4. Knee Raises w/full body extension 5. Side Elbow Plank 6. Swan 7. Crunch - Around the World

http://www.abbieappel.com/




Cool New Tools and Programming for Boot Camps & Group Ex! By Marc Lebert - This session is sure to keep your Group X and Boot Camp sessions fresh, fun and challenging with the amazing portable Lebert Equalizer™ and Lebert Buddy System™! Everything from agility and mobility drills, compound bodyweight movements, unique uni-lateral rowing and manual resistance exercises, partner training, athletic conditioning drill sequences, unique class programming and more! Your toolbox will be full after this one! LEBERT EQualizer® EXERCISES

Vertical Rows Cueing hips up and head back starting position. Basic row with many modifications to suit any level

Incline Push ups Foot positioning and variations

Dips Leg Assisted

Leg Raise and “Running Person” Progressions

Kneeling Tricep Extensions Personal fave!

Hip Raise Working with the posterior chain

Split Squats Balance, strength and stretch all in one

Cardio Ideas Using the Equalizers™ for various cardio movements

Stretch Hip/glute, hamstring, adductor, quads

LEBERT EQualizer® Programming The EQUALIZER™ was originally designed to perform a body weight pull up but we will cover much more with this programming, including agility ladder drills, body weight training and boot camp conditioning. NOTES:



LEBERT BUDDY SYSTEM™ EXERCISES

Unilateral Rows Wide base of support, head and chest up, long smooth pulling

Bilateral Rows You can really “feel” if your client is working here!

Swimming Feet close and upper body slightly hinged forward. Pull behind you

Cross-Bow Rear delts, chest fly, and core all in one exercise!

Legs Why the Buddy System makes for a great assist when squatting

LEBERT BUDDY SYSTEM™ Programming Once you try the BUDDY SYSTEM™ you won’t want to put it down! And for 10 minutes we won’t!

highly efficient sets of muscle endurance

multi-planar/multi-directional

manual resistance

resisted running NOTES:


DIET SMACK-DOWN: Vegan vs. Paleo By Zonya Foco, RD, CSP

Wednesday March 30, @ 9:30 am and 2:30 pm

Should we eat vegetarian, or like a caveman? With wheat and dairy or without? With so many opposing endorsements, what’s the best choice? In an effort to truly understand the pro’s and con’s of each diet, Zonya reports on her personal study where she subjected herself to eating Vegan for 30 days, followed by eating Paleo for 30 days. She presents not only what she ate and how she felt, but also the changes in her weight, body fat percent, blood cholesterol, HDL, LDL & triglycerides after each diet, as well as a comprehensive dietary analysis of each. How easy was each diet? What impact did each have? Did each provide all the necessary nutrients? You will leave with a firm understanding of the benefits and shortcomings of each diet, helping you to help others avoid potential pitfalls of each diet, and also take the best from each approach, creating a realistic and successful eating style for life.

After attending this session, participants will be able to:

1) Explain the strengths and weaknesses of each of the two rigid eating styles. 2) Advise clients how to avoid common pitfalls of both diets, to ensure they are a

healthy “vegan” or “palean.” 3) Teach a blended “pagen” eating style that captures the strengths of both, for a less

restrictive and more realistic eating pattern that the entire family can enjoy.

Outline I. What the Vegan Diet is


II. What the Paleo Diet is


III. Analysis of my 30-day experiment on each diet

a. Nutrition analysis: what did each diet lack? b. Weight and BF% changes c. Lipid profile changes d. “enjoyment” factor of each

e. Which one would I like to live for the rest of my life?

IV. Analysis of a blended, no processed foods “pagen” eating style a. Nutrition analysis: is it more complete than either of the above? b. Is it more enjoyable long term? c. Does it give the same health benefits?

V. Group Discussion and Q/A

a. What provides the successful weight loss component of each diet? b. What is it that provides the successful improvements in health? Including

inflammatory diseases?

VI. Conclusions a. Three cautions for people eating Paleo b. Three cautions for people eating Vegan c. A blended approach that’s simple to teach, and easy to live, especially for

the whole family.

It Hurts But Can I Still Workout? Practical Tips, Tools and Strategies for Working with and Around Exercise-Related Injuries: Principles and Precautions.

Steve Blivin, MD, FAAFP, FACSM United States Navy

Peter Ronai, MS RCEP, CEP, EP-C, FACSM Clinical Associate Professor Exercise Science

Sacred Heart University ACSM Health & Fitness Summit

1. Introduction (Pete) a. Presentation outline/objectives

i. To teach exercise professionals how to help clients safely maintain/improve their physical Conditioning /function while recovering from/completing rehabilitation for exercise-related injuries.

ii. To select and (when appropriate) modify/substitute specific exercises considered “appropriate” for a healing or post-rehabilitation client.

iii. To identify’ symptoms/“red flags” warranting referral back to a physician/healthcare provider iv. Communicate effectively with clients’ physician/healthcare provider

b. Brief CASE INTRODUCTION

2. "What Is Pain" and What is it Good for? (Steve) a. Definitions

i. Subjective Descriptions ii. Acute versus Chronic

b. A Warning System i. Decreases Risk of ongoing damage

ii. Tissues undergo characteristic phases of healing activity c. Pain can be deceiving

i. Not always an indicator of tissue strength and healing ii. Not always an indicator of tissue damage either

d. Role of Exercise Professionals (Pete) i. Understand how tissue(s) and injuries heal

ii. Understand their scope of practice iii. Develop safe, effective exercise programs in conjunction with physician/healthcare provider

guidelines iv. Communicate with client and physician/healthcare provider

3. Concerns for Considerations During Exercise (Pete)

a. Exercisers often use pain as a guide for return to activity and tissue health i. Pain levels often decrease well before tissue healing is complete

ii. Exercisers might believe they can return to workouts before the body is actually ready

b. Never overstress healing tissue (Steve)

i. Appropriately controlled therapeutic stress is needed to optimize collagen matrix formation ii. Client progress from one phase of healing to the next

iii. Progress dictated by specific objectives (established by the physician and/or physical therapist iv. New/worsening symptoms and/or reduced function warrant referral back to physician/healthcare

provider ASAP!!!! v. Use log book with pain scales to prevent injuries and maximize progress!!!

4. Reconditioning Considerations (Pete)

a. Inflammation Stage i. Preventing disruption of new tissue

ii. *Exercise Strategies- General aerobic and anaerobic training and resistance training of uninjured extremities, with priority given to maximal protection of the injured area

b. Repair/Proliferation Phase i. Preventing excessive muscle atrophy and joint deterioration in the injured area; maintaining

muscular and cardiovascular function in uninjured areas c. Remodeling Phase

i. Optimizing tissue function by continuing and progressing the activities performed during the repair phase

ii. *Exercise Strategies -Transition from general exercises to sport or gym/workout exercises

5. Management (Steve)

a. "Considerations-Principles" (Steve) i. A Gradual, Progressive Return to Activities - Allow tissue recovery ii. Prevent worsening injury

iii. Unknown or uncertain diagnosis iv. Physician/healthcare provider must establish time frames for recovery and testing v. Provide alternate activities vi. Be cautious, but not overly conservative, (line between rest and deconditioning)

b. STOP DOING WHAT HURTS i. Strength, Flexibility, Proprioception, Team Approach (Physician, PT, ATC, Personal Trainer)

ii. Do something else and work around it c. Drugs/Medications

i. NSAIDs ii. Narcotics

iii. Other- Muscle relaxants, TRUE Muscle relaxants iv. Injected v. Topical

d. Surgery - Correct the anatomy, remove injured tissue, Stabilize joint i. “Cleaning out a Joint” and/or “Stabilizing” a joint ii. Replacing a joint (Hip, knee & shoulder most common)

6. Alter Activities (Pete)

a. Practical suggestions-Change Technique and Motions - Directional Preferences Might Occur in Some Instances

i. Must know the activity/exercise activity and understand the Basic “Biomechanics” of it/them ii. Personal Trainers don’t play doctor

b. Proper Instruction-Qualified Personal Trainers and Exercise Physiologists –“Exercise Is Medicine”™ i. Proper Equipment/Machine Fit and Use

ii. Proper Warm-up and Exercise techniques 7. Wrong diagnosis, Additional diagnosis, Poor compliance (Steve)

a. Ask the physician/healthcare provider, What could we have missed? i. Depression ii. Bone contusion or fracture w/ ligament injury

iii. Compartment syndrome w/ fracture or soft tissue injury iv. Cast/splint/brace too tight, Infection/abscess under wound, Nerve injury

b. Non-compliance with treatment i. Doing too much

ii. Not wearing splint or using crutches iii. Not taking medicines iv. Fear of addiction, Spreading out doses, Fear of running out, Cost, Diversion

8. CASE STUDIES (Please Help Mr. Smith!!!) a. 38 y/o engineer completed 12 weeks physical therapy for R rotator cuff impingement/tendonitis (physician

cleared him to exercise/workout!!!) Full strength & full R.O.M., no swelling or difficulty w/ADLs

b. Typical Workout 3x/week: • Low Bar Rear Squats (10, 8, 6, 3, 3) • Behind the Neck Press (3 x 6) • Wide Bench Press (10, 6, 3, 3, 2) • Rear Lat Pull-down (3 x 10) • Parallel bar Dips (4 x 10 weighted) • Chest Flys (3 x 12) • Overhead Dumbbell Tricep Press (4 x 10) • Incline Dumbbell Bicep Curls(4 x 10) • Supine Triceps Extensions (4 x 8) • Biceps Preacher Curls (4 x 10) What is Wrong Here?

• Start with exercises to build a stable base (scapula). • Add exercises to strengthen the rotator cuff muscles. • Add compound exercises. Emphasize synchronized motion between the scapular stabilizer and rotator cuff muscles.

(general exercises)—remember not normal for probably 9 months!!! • Add exercises which challenge balance, stability and proprioception (i.e., position sense). • Modify exercise techniques of commonly performed workout activities. Avoid pain!!!!

• Contact MD immediately if new or worsening symptoms occur!!!

c. Cases from the audience if time permits.

9. Four Take Away Messages

a. Personal trainers must operate within their scope of practice when working with clients with painful conditions. New pain, worsening pain or pain not improving as expected warrants immediate physician referral.

b. Physicians provide a compliment of diagnostic, surgical and treatment services which can improve physical activity tolerance in patients experiencing chronic pain.

c. Exercisers often use pain as a guide for return to activity and of tissue health and healing but pain levels often decrease well before tissue healing is complete. Exercises must neither under stimulate nor overstress healing tissues. Don’t ignore pain.

d. Knowledgeable personal trainers can help their clients improve their health and fitness levels while they are healing without increasing their risk(s) of injury or re-injury.

2016 Health and Fitness Summit Avery Faigenbaum, EdD, FACSM


March 29-April 1, 2016

Medicine Ball for All Kids

Avery D. Faigenbaum, Ed.D., FACSM Professor, Department of Health and Exercise Science

The College of New Jersey

[email protected] @afaigenbaum

Summary

Current trends in physical inactivity among children and adolescents highlight the importance of developing youth fitness programs that are safe, effective, and creative.

In addition to active games and outdoor activities, regular participation in structured strength-building activities should also be incorporated into the weekly routine of

school-age youth. Since a certain amount of muscular strength is needed to be an efficient “mover” on the playground and sport field, the importance of integrating strength-building activities into youth fitness classes should not be overlooked. Youth

who are not exposed to an environment with opportunities to enhance their muscle strength and motor skill proficiency early in life may not develop the prerequisite skills

and abilities that would allow them to participate in a variety of activities and sports with confidence and vigor later in life.

At present, a growing number of fitness centers and sport training clubs offer youth fitness programs that include various forms of resistance exercise. Different modes of

training including body weight, free weights, weight machines, elastic bands and medicine balls have proven to be safe and effective in youth programs. Of note,

medicine ball training provides children and adolescents with the opportunity to strengthen their bodies through dynamic movements that require balance and coordination. Not only are medicine balls relatively inexpensive, but medicine ball

training can add variety and creativity to youth fitness programs. In this interactive workshop, the FUNdamental principles of medicine ball training for kids will be

discussed, the PROCESS of youth fitness will reviewed, and attendees will have an opportunity to “act like kids” while training their developing brain with medicine ball

games, activities and exercises. I. Introduction and overview

A. First things first: What happened to free play? B. The unfitness epidemic: Slower, lower and weaker?

C. Why is strength important?



II. Kids are not miniature adults A. Strength drives motor skill performance which drives MVPA

B. Have fun, make friends and learn something new

III. Understand the PROCESS of youth fitness

A. Progression B. Regularity

C. Overload D. Creativity

E. Enjoyment F. Socialization G. Supervision

IV. Medicine Ball Basics

A. Benefits of medicine ball training B. Train the developing brain C. Program design variables

D. Safety first

V. Med Ball for All Kids A. Warm-up activities

B. Lower body exercises C. Upper body exercises D. Core exercises

E. Specialty exercises F. Get creative

G. Training with balloons V. Three take-away points

1. Developmentally-appropriate interventions are needed to increase physical activity

among youth by emphasizing instructional classes that enhance muscular strength and improve motor skill performance.

2. Medicine ball training offers an inexpensive and effective method of training that can help youth learn about the components of physical fitness while acquiring the skills and

abilities they need to support an active lifestyle. Medicine ball training can also provide children with an opportunity to have fun while gaining competence and confidence in

their physical abilities.

3. Fitness professionals who understand the PROCESS of youth fitness can develop lessons that enhance muscular strength, develop fundamental movement skills, foster new social networks and promote healthy behaviors in a positive and supportive

environment.


Selected References

Bukowsky, M., Faigenbaum, A. Myer, G. Fundamental integrative training (FIT) for

Physical Education, Journal of Physical Education, Recreation and Dance, 85: 23-30, 2014.

Chu, D., Myer, G., Plyometrics. Human Kinetics: Champaign, IL, 2013 Faigenbaum, A., Bush J., McLoone, R et al. Benefits of strength and skill-based training during primary school physical education. Journal of Strength and Conditioning Research, 29: 1255-1262, 2015. Faigenbaum, A., Farrell, A., Fabiano, M., et al. Effects of integrated neuromuscular

training on fitness performance in children. Pediatric Exercise Science, 23: 573-584, 2011.

Faigenbaum, A., Lloyd, R., MacDonald, J.,Myer, G. Citius, Altius, Fortius: beneficial

effects of resistance training for young athletes: narrative review. British Journal of Sports Medicine, 50: 3-7, 2016.

Faigenbaum, A., McFarland, J. Resistance Training for kids: Right from the start, ACSM Health and Fitness Journal, in press.

Faigenbaum, A. Westcott, A. Youth Strength Training. Human Kinetics: Champaign, IL, 2009.

Lloyd RS, Faigenbaum AD, Stone MH, et al. Position statement on youth resistance

training: the 2014 International Consensus. British Journal of Sports Medicine, 48: 498-505, 2014.

Mediate, P., Faigenbaum, A., Medicine Ball for All Kids, Healthy Learning: Monterey, CA, 2007

Myer, G., Faigenbaum, A., Edwards, et al. Sixty minutes of what? A developing brain perspective for activating children with an integrative exercise approach. British Journal of Sports Medicine, 49: 1510-1516, 2015 Useful websites for more information on youth physical activity:

o www.acsm.org

o www.shapeamerica.org

o www.fitness.gov

o www.pecentral.org

o www.naspem.org

http://www.ncbi.nlm.nih.gov/pubmed/?term=Lloyd%20RS%5BAuthor%5D&cauthor=true&cauthor_uid=24055781

http://www.ncbi.nlm.nih.gov/pubmed/?term=Faigenbaum%20AD%5BAuthor%5D&cauthor=true&cauthor_uid=24055781

http://www.ncbi.nlm.nih.gov/pubmed/?term=Stone%20MH%5BAuthor%5D&cauthor=true&cauthor_uid=24055781

2/24/2016

1

FOAM ROLLING: RE-GEN

Presented by: Master Trainer

Foam Rolling: Re-Gen

FOAM ROLLING

• Applying bodyweight compression across a tool to induce changes in soft tissue.

• Compression can decrease and increase blood flow, flushing out metabolic waste and bringing nutrient rich blood to the area.


MICROTRAUMA

• Chemicals inside the cell end up being on the outside of the cell

• Excites nociceptors—brain interprets this as “danger” and is felt as pain


MUSCLE SORENESS

What doesn’t cause it?

Robergs, R.A., Ghiasvand, F. & Parker, D. (2004). Biochemistry of exercise-induced metabolic acidosis. American Journal of Physiology: Regulatory, Integrative, and Comparative Physiology, 287, 502-516.


MUSCLE SORENESS


What happens during a workout…

Kravitz, L. (2004). Lactate: Not guilty as charged [Review of the article Biochemistry of exercise-induced metabolic acidosis, by R.A. Robergs, F. Ghiasvand, & Parker, D.]. American Journal of Physiology, Integrative, and Comparative Physiology, 287, 502-516.

2/24/2016

2


RESEARCH

• Rolled for 60 seconds• Increases in ROM• Increase in performance on

subsequent workouts (48 and 72 hours)

• Muscle soreness decreased the most at 48 hours

MacDonald, G., Button, D., Drinkwater, E. & Behm, D. (2014). Foam rolling as a recovery tool following an intense bout of physical activity. Medicine & Science in Sports & Exercise, 46(1). 131-140.


WHY?

Thomas, C. & Lumb, A.B. (2012). Physiology of haemoglobin. Continuing Education in Anesthesia, Critical & Pain Advance Access.


REPETIVE STRAIN INJURIES

Musculoskeletal disorders account for 32% of all workplace injuries

U.S. Department of Labor. (2015). Nonfatal occupational injuries and illnesses requiring days away from work, 2014.(USDL Publication No. 15-2205). Washington, DC: U.S. Government Printing Office.


OVERTRAINING?

Up to 90% of participants injured in the first 6 weeks of exercise program• Sedentary individuals trying

to make a change

Jones, B.H., Cowan, D.N. & Knapik, J. (1994). Exercise, training, and injuries. Sports Medicine, 18(3), 202-214.


CALVES


TIBIALIS ANTERIOR

2/24/2016

3


ILTIOTIBIAL BAND


HAMSTRINGS


GLUTES


THORACIC SPINE


PECTORALS


LATISSIMUS DORSI

Activity Trackers: Reaching the Non-Movers 2016 Health & Fitness Summit, Orlando

Carol Kennedy-Armbruster, PhD., Indiana University; School of Public Health, [email protected]

Dixie Stanforth, Ph.D., The University of Texas at Austin; Kinesiology & Health Education, [email protected]

KEY TAKE-AWAYS 1. History of fitness industry/how AT’s fit into current movement practices 2. Pros/cons of tracking devices 3. How to incorporate potential positive benefits of AT’s into your business A. TRACKING THE FITNESS INDUSTRY 1. The Fitness “Boom?”

• More than one-third (34.9% or 78.6 million) of U.S. adults are obese. [http://jama.jamanetwork.com/article.aspx?articleid=1832542]

• The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight. [http://content.healthaffairs.org/content/28/5/w822.full.pdf+html]

• Percent of adults 18 years of age and over who met the Physical Activity Guidelines for aerobic physical activity: 49.2%

• Percent of adults 18 years of age and over who met the Physical Activity Guidelines for both aerobic physical and muscle-strengthening activity: 20.8% (c&d: CDC/NCHS, National Health Interview Survey, 1997-2014, Sample, Adult Core component.)

2. If the Boom is Bust for a majority, how do we engage the non-movers?

• Fitness enthusiast “shuffle” • Barriers to entry/uninitiated believers/who are they? (Tharrett & Peterson) • Fitness/training/exercise vs activity/movement paradigm/ACE IFT model

B. ACTIVITY TRACKERS: USE IT OR LOSE IT? 1. Bullish on trackers

• In 2015, 39.5 million U.S. adults 18 and over used wearable devices, including smartwatches and fitness trackers. This represents an increase of 57.7 percent over 2014, according to eMarketer. They predict substantial growth, with 81.7 million adults using wearables by 2018.

• Second half of 2015: Apple sold ~7.5 million watches; Fitbit sold ~9.2 million fitness trackers, more than double the number of devices sold in same two quarters of 2014.

• Sept. 15, 2015: Target announces 335,000 employees will get a Fitbit. • Dec. 25, 2015: top downloaded app in the Apple App store? Fitbit app.



http://www.emarketer.com/newsroom/index.php/wearable-usage-grow-60-year/

2. Bearish on trackers • Despite popularity, consumer behavior research notes common flaws leading about

1/3 purchasers to abandon use within 6-12 months. Common complaints? Easily lost or breakable, not waterproof, difficult to synch with smartphones, have a short battery life, are ugly, uncomfortable, and provide no material benefit. (Inside Wearables, Part 2.)

• Numerous research studies highlight compliance problems due to poor reliability, lost trackers, irregular use, questionable data/competitive outcomes, gender differences, etc. (Harrison et al., 2015)

• Concerns summarized? “Despite the uptake of wearable activity trackers, they fail to sustain user engagement and impact users’ behaviors.” (Karpanos et al., 2015)

C. TRACKING THE RESEARCH 1. Do activity trackers use behavior change techniques (BCT) to help users?

• A recent content analysis indicates YES! Lyons et al. note that “Of the 14 BCTs identified as potentially effective based on their success in previous interventions, five were widely represented across the devices: goal-setting (behavior), review of behavioral goals, feedback of behavior, self-monitoring of behavior, and rewards. Problem solving, action planning, commitment, instruction on how to perform the behavior, and behavioral practice were rare.

2. Can trackers leverage behavior change research to target the non-movers? • Studies highlight integration of a wide range of behavior change theory, from

traditional options such as Self-Determination or Social Cognitive Theory (for example Gonveia et al., or Shih et al.) to the competitive Fun Theory (http://www.thefuntheory.com/fun-theory-award).

3. Carol’s research with Activity Trackers at Indiana University • Program data/Meaningful outcomes (Kiessling/Kennedy-Armbruster, 2016) • Programmatic changes to utilize lessons learned • Transtheoretical Model (Nigg, 2014)

4. Those in contemplation and preparation are more likely to adopt a new behavior (i.e., Gouveia, Shih or Rosencranz)

• How many non-movers (pre/contemplators, preparers) own an activity tracker? • Could we use trackers to extend to the development of other healthy habits? (See

Endeavor Partners 2016 Wearable report) D. TRACKING “IN THE WILD:” THOUGHTS AND STORIES FROM THE FIELD 1. Will activity trackers become part of exercise as medicine?

• “Wearable technology is beginning to emerge as a powerful tool to transform chronic disease prevention, and there are huge financial incentives at stake.” [Endeavour Partners 2016]

• Wired.com, Nov. 6, 2014: “While only 19 percent of people with no chronic conditions track their health indicators, 40 percent of adults with one chronic condition do so, and 62 percent of adults with two chronic conditions do so…People with chronic diseases don’t suddenly decide that they’re over it and the novelty has

http://www.thefuntheory.com/fun-theory-award

worn off. Tracking and measuring—the quantified self—is what keeps them out of the hospital.”

• c. Usage based insurance and beyond: no more cheating trackers! [Saeb et al., 2015] 2. Can activity trackers help grow your business?

• Let’s do it! 80% of clubs business will come from within a 12 minute radius, which most often equates to a 3 miles radius. The secondary market typically extends to 20 minutes or 5 miles. It’s better to look at time than distance.

• Brainstorm and share References

• Endeavor Partners, Inside Wearables Parts 1-3: http://endeavourpartners.net/white-papers/inside-wearables/

• Gonveia, R., et al. (2015). How do we engage with activity trackers?: a longitudinal study of Habito. Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing. Osaka, Japan, ACM: 1305-1316.

• Harrison, D., et al. (2015). Activity tracking: barriers, workarounds and customization. Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing. Osaka, Japan, ACM: 617-621.

• Karapanos, E. (2015) Sustaining user engagement with behavior change tools. Interactions 22, 4 (June 2015), 48-52.

• Kiessling, B. & Kennedy-Armbruster, C. (2016) Behavioral Aspects of Activity Trackers, Move more, sit less? ACSM Health and Fitness Journal, (in press).

• Lyons EJ, Lewis ZH, Mayrsohn BG, Rowland JL. Behavior Change Techniques Implemented in Electronic Lifestyle Activity Monitors: A Systematic Content Analysis. J Med Internet Res 2014;16(8):e192

• Nigg, C. (2014) ACSM’s Behavioral Aspects of Physical Activity, Lippincott Williams and Wilkins

• Rosencranz RR, Duncan MJ, Caperchione CM, Kolt, GS, Vandelanotte C, Mader AJ, Savage TN, Mummery WK. Validity of the Stages of Change in Steps instrument (SoC-Step) for achieving the physical activity goal of 10,000 steps per day. BMC Public Health 2015: Nov 30; 15:1197. doi: 10.1186/s12889-015-2539-y.

• Sohrab Saeb, Konrad Körding, David C. Mohr. Making Activity Recognition Robust against • Deceptive Behavior. PLOS ONE, 2015; 10 (12): e0144795 DOI:

10.1371/journal.pone.0144795 • Tharrett, S & Peterson, J. (2012). Fitness Management, Healthy Learning, Monterey, CA.

Blogs/websites/presentations:

• http://well.blogs.nytimes.com/projects/activity-trackers • http://well.blogs.nytimes.com/projects/2014/03/accelerometers.html • http://www.wsj.com/articles/review-best-fitness-trackers-to-get-you-up-off-the-couch-

1418760813 • Wareable.com. http://www.wareable.com/fitness-trackers • CIO.com. http://www.cio.com/article/3017995/wearable-technology/13-wearable-tech-

trends-to-watch-in-2016.html • CIO.com. http://www.cio.com/article/2973574/wearable-technology/6-reasons-why-

apple-watch-will-kill-activity-trackers-and-6-reasons-it-wont.html • Use and Adoption of wearable Activity Trackers:

https://www.ideals.illinois.edu/handle/2142/73649

http://endeavourpartners.net/white-papers/inside-wearables/

http://endeavourpartners.net/white-papers/inside-wearables/

http://well.blogs.nytimes.com/projects/activity-trackers

http://well.blogs.nytimes.com/projects/activity-trackers

http://well.blogs.nytimes.com/projects/2014/03/accelerometers.html

http://www.wsj.com/articles/review-best-fitness-trackers-to-get-you-up-off-the-couch-1418760813

http://www.wsj.com/articles/review-best-fitness-trackers-to-get-you-up-off-the-couch-1418760813

http://www.wareable.com/fitness-trackers

http://www.cio.com/article/3017995/wearable-technology/13-wearable-tech-trends-to-watch-in-2016.html

http://www.cio.com/article/3017995/wearable-technology/13-wearable-tech-trends-to-watch-in-2016.html

http://www.cio.com/article/2973574/wearable-technology/6-reasons-why-apple-watch-will-kill-activity-trackers-and-6-reasons-it-wont.html

http://www.cio.com/article/2973574/wearable-technology/6-reasons-why-apple-watch-will-kill-activity-trackers-and-6-reasons-it-wont.html

https://www.ideals.illinois.edu/handle/2142/73649

[email protected] // www.danmcdonogh.com


March 2016

Get if from the Ground – Bodyweight Training

Dan McDonogh Sr. Manager of Performance Training – Under Armour

2012 Fitness Instructor of the Year – IDEA Health & Fitness Association [email protected] // www.danmcdonogh.com

Overview This body-weight only session is based on movement not muscle. Our ability to manage the spine and manage the knee while we Push, Pull, Hinge, Squat and Lunge without external load is paramount before adding load & complexity. This session will be a progressive bodyweight only workout that will build with intensity & complexity and at the same time help you develop Strength, Stability & Mobility to help you move and perform better! Learning objectives:

1) Be exposed to Foundational Movements and best practices around cueing them - Plank/Push/Pull/Hinge/Squat/Lunge 2) Participate in an exercise library based on Foundational Movements - 3 blocks of work, - 6 movements per block - Each block builds with intensity & complexity 3) Have a new found appreciation for Body-weight only training and effective it can be

for increasing strength, stability & mobility but how it can be used to assess how one moves.

I. Introduction and Overview A. The importance of being able to manage movement without load before adding load B. How all movement stems from the our ability to manage the spine (Plank) II. Workout

A. A 45 minute body-weight only workout (3 blocks, 6 exercises/block) based on Plank, Push, Pull, Hinge, Squat & Lunge

III. Q & A



1

Session Outline ACSM’s 20th Health & Fitness Summit & Exposition

March 29 – April 1, 2016 The Hilton Orlando Lake Buena Vista, Orlando, FL

Legal Duties to Properly Hire, Train, and Supervise Employees:

Essential Competencies for Fitness Managers and Program Supervisors

JoAnn M. Eickhoff-Shemek, Ph.D., FACSM, FAWHP Professor, Exercise Science University of South Florida

Tampa, FL [email protected]

Fitness managers and program supervisors (e.g., personal training and group exercise coordinators) have many legal duties related to hiring, training, and supervising their employees. Using case law examples, this presentation will focus on these duties and discuss important competencies (knowledge/skills) needed to help managers adhere to these duties. Hiring competencies include interviewing techniques to adequately assess a candidate’s knowledge/practical skills. Training competencies include initial education on providing safe instruction within one’s scope of practice as well as continual education on fitness safety. Supervision competencies include observing and evaluating job performance upon hiring and on a regular basis.

I. Overview of Negligence a. Definition b. Four elements the plaintiff must prove c. Legal Principle – Respondeat Superior d. Legal Liability Exposures in Fitness Facilities/Programs

II. Negligence – Case Examples a. Proffitt v. Global Fitness Holdings, LLC, et al. b. Baldi-Perry v. Kaifas and 360 Fitness Center, Inc.

III. Hiring Employees a. The Credentialing Dilemma b. Interview Techniques c. Establishing Scope of Practice Policies/Procedures

IV. Training Employees a. Initially Upon Hiring b. Regular In-service Trainings

V. Supervising Employees a. Informal b. Formal

i. Direct Observation ii. Written Performance Appraisal

iii. Feedback/Action Plan VI. Documentation of Procedures

a. Hiring b. Training c. Supervision

Take Away Points -- Fitness Managers/Supervisors will be able to:

1. Understand how courts apply the doctrine of respondeat superior in negligence cases. 2. Develop specific managerial competencies related to proper hiring, training, and supervision of employees. 3. Protect themselves and their businesses against common negligence claims/lawsuits.


2

I. Overview of Negligence (1)

a. Definition: Negligence is “failing to do something” that a reasonable, prudent professional would have done or “doing something” that a reasonable, prudent professional would not have done, given the same or similar circumstance. Negligent conduct is “careless” conduct – either by omission (failure to perform) or commission (improper performance).

b. Four elements the plaintiff must prove i. Duty – the duty or standard of care the defendant (health/fitness professional and/or

facility) owes to the plaintiff (injured party) ii. Breach of duty – the defendant’s conduct did not meet the standard of care

iii. Causation – the breach of duty was the “cause” of the plaintiff’s injury iv. Harm/damages – the harm that occurred to the plaintiff resulting in damages (losses) to

the plaintiff c. Respondeat Superior – legal principle in which employers can be held liable for the negligent

acts of their employees. d. Legal Liability Exposures in Fitness Facilities/Programs

Many legal liability exposures exist in each of the following seven areas: (1) Employment issues, (2) Pre-activity health screening, (3) Health/fitness assessment and prescription. (4) Instruction and supervision, (5) Exercise equipment, (6) Facility issues, and (7) Medical emergency action plans (EAPs). Focus will be on employment issues – hiring, training, supervising of employees

II. Negligence – Case Examples a. Proffitt v. Global Fitness Holdings, LLC, et al. (2)

After Proffitt’s first training session with his personal trainer, he was diagnosed with rhabdomyolysis, hospitalized for 8 days, and suffered many injuries. In his negligence lawsuit, Proffitt made several claims against the trainer as well as the trainer’s employer. Proffitt claimed that the employer failed to ensure that their employee was properly trained to (a) investigate Proffiit’s health history, (b) assess his physical fitness and fitness abilities, and (c) determine an appropriate training regimen for him. Case was settled for $75,000.

b. Baldi-Perry v. Kaifas and 360 Fitness Center, Inc.(3) Baldi-Perry had informed her personal trainer (Kaifas) of her back and neck injuries. He assured her that he had extensive experience in training individuals with these types of injuries. After Kaifas had her perform a new routine, she suffered many injuries and some required surgery. In her negligence lawsuit, Baldi-Perry made over 25 claims against the trainer and 14 claims against the trainer’s employer including their failure to (a) hire properly trained and/or certified trainers, (b) hire trainers who were qualified to design exercise programs for individuals with injuries, and (c) to offer appropriate and necessary training to physical trainers. The case resulted with a jury verdict ($1.4 million) against the trainer and facility.

III. Hiring Employees a. The Credentialing Dilemma

Given the health/fitness profession is self-regulated (through certification and accreditation) and not government-regulated through licensure or statutory certification, it cannot be assumed that those who are “certified” or who possess an “accredited certification” will automatically be competent employees. There is a difference between qualified (e.g., possesses certain credentials) and competent (e.g., possesses the knowledge and skills to design/deliver a safe and effective exercise program).

b. Interview Techniques Several interview techniques can be used to determine if a candidate has the knowledge and skills to properly perform a job such as a personal trainer or group exercise leader. These include (a)

3

asking questions that will help determine their knowledge/skills, (b) asking situational-type questions (situations that often come in personal training sessions/group exercise classes), and (c) have them teach a mock personal training session or a mock group exercise class. Evaluating the interview performance of each candidate is essential.

c. Establishing Scope of Practice Policies/Procedures Practicing outside one’s scope can happen (a) when an exercise professional does not possess the necessary knowledge and skills to properly design/deliver an exercise program, e.g., the trainer in Proffitt did not conduct screening, fitness assessments, and design/deliver a safe program, and (b) when an exercise professional trains someone with medical conditions and does not have the advanced knowledge/skills to safety train “that” individual as the trainer in Baldi-Perry. Managers/supervisors need to be sure their fitness staff members are not only qualified and competent but practice within their scope. Advanced knowledge and skills are needed to design and deliver exercise programs for clinical populations (Warburton et al., 4). Written “scope of practice” polices and procedures should be developed.

IV. Training Employees a. Initially Upon Hiring

Initial training helps ensure your fitness staff members will perform their jobs properly and within in facility’s policies and procedures. Training provides an opportunity for management to emphasize a “safety” culture and that participant safety is #1 responsibility of all employees. Training prevents “crisis management” and enhances the delivery of quality (safe/effective) programs and services.

b. Regular In-Service Trainings Regular “safety” trainings are needed to review the safety policies/procedures and to focus on strategies that continually improve safety.

V. Supervising Employees a. Informal

Informal supervision involves giving feedback to an employee right after observing that a job function was performed improperly.

b. Formal Formal supervision involves direct observation of a staff member’s job performance, e.g., using a written performance appraisal tool to evaluate a group exercise instructor for an entire class or a personal trainer for an entire training session. Once completed, a formal feedback session is needed between the manager/supervisor and the employee. An action plan should be established for job tasks that need improvement. For new employees on probation, this should be completed at least twice during the probationary period and for all employees, at least once/year.

VI. Documentation of Procedures Having documentation of hiring, training, and supervision procedures can serve as evidence in defending a negligence lawsuit.

References

1. Eickhoff-Shemek, JM, Herbert, DL & Connaughton, DP. (2009). Risk Management for Health/Fitness Professionals: Legal Issues and Strategies. Baltimore, Maryland: Lippincott Williams & Wilkins.

2. Proffitt v. Global Fitness Holdings, LLC, et al. In: Herbert DL. New lawsuit against personal trainer and facility in Kentucky – rhabdomyolysis alleged. The Exercise, Sports and Sports Medicine Standards & Malpractice Reporter. 2013;2(1):1,3-10 and Rhabdomyolysis lawsuit in Kentucky settled. (2013). The Exercise, Sports and Sports Medicine Standards & Malpractice Reporter. 2013;2(4):58.

3. Baldi-Perry v. Kaifas and 360 Fitness Center, Inc. In: Herbert DL. New York case against personal trainer results in $1.4 million verdict. The Exercise, Sports and Sports Medicine Standards & Malpractice Reporter. 2015;4(4):49, 51-55.

4. Warburton DER, Bredin SSD, Charlesworth SA, Foulds HJA, McKenzie DC, Shephard RJ. Evidence-based risk recommendations for best practices in the training of qualified exercise professional working with clinical populations. Appl Physiol Nutr Metab. 2011;36:S232-S265. doi: 10.1139/H11-054.

SIGN UP FOR THE SOY STUDY SHARE

Please SIGN UP to receive monthly summaries of the latest soy and health research .

SESSION SUMMARYChoosing the right foods pre- and post-workout is an important part of gaining lean muscle mass, endurance, satiety and optimal muscle recovery. Research shows the right blend of soy and dairy proteins can extend the muscle building period after exercise. Our panelists — a registered dietitian for a professional sports team and an exercise physiologist — bring to life the latest protein research, provide techniques on how to accurately communicate scientific research, and offer the benefits and tips to incorporating soy protein into your training regimen.

SPEAKERSDR. BLAKE RASMUSSEN, PHD is the Chair of the Department of Nutrition and Metabolism at the University of Texas Medical Branch at Galveston. He is the Director of the NIH-funded Muscle Biology & Metabolism Laboratory. Dr. Rasmussen has published over 90 research papers. [email protected] | research

MARIE A. SPANO, MS, RD, CSCS, CSSD, is a nutrition communications expert and one of the country’s leading sports nutritionists. She is the sports nutritionist for the Atlanta Hawks and nutrition coach for many college and pro athletes. [email protected] | @mariespano

OBJECTIVES & TAKE AWAYSIn this session, you will learn to:

1. Learn about protein quality and how to communicate the benefits of a variety of protein sources

2. Understand how different types of high-quality protein stimulate muscle protein synthesis and how to use this information to design optimal nutritional recovery strategies

3. Apply the latest evidence on the role of protein blends in aiding muscle recovery following exercise and their potential use in sports nutrition

4. Communicate complex nutrition research to clients in language they understand and can apply while retaining scientific credibility

After exercise, the intake of complete protein is key to muscle building and repair. Soy protein provides an “intermediate” rate of amino acid release, and when combined with other proteins, such as whey and casein, offers a sustained delivery of amino acids to muscles. This soy-dairy blend is ideal for long-term increase in lean muscle mass. Soy is also beneficial for athletic performance and muscle recovery, and is rich in antioxidant compounds that may help reduce oxidative stress associated with exercise.

SUSTAIN THE GAINProtein Balance for Lean Muscle

MATERIALS FOR YOUR CLIENTS

Clearing Up Confusion Over Soy Fact Sheet

The Role of Soy in the Performance of Active and Athletic Americans SCANNERS Article

Safety of Soyfoods Fact Sheet from the Academy of Nutrition and Dietetics

Protein Chart and Food Ideas

The Switch to Plant Protein Made Easy with Soy

Shopping for Soy Infographic

Deciphering the Code: Soy’s Simple Facts on Labeling

Soyfoods Month Recipe Booklet

http://www.soyfoods.org/sports-fitness-professionals

http://shp.utmb.edu/nutr/facultyandstaff_bio_rasmussen.asp

mailto:blrasmus%40utmb.edu

https://utmb.influuent.utsystem.edu/en/persons/blake-b-rasmussen%25284d9251e8-9cc9-41e8-997f-7b2b47442b91%2529.html

http://www.mariespano.com/

mailto:marie%40mariespano.com

https://twitter.com/mariespano

http://www.soyfoods.org/wp-content/uploads/SCAN_Clearing-Up-Confusion-Over-Soy_Final.pdf


http://www.soyfoods.org/wp-content/uploads/2014-update-to-scannners-article.pdf



http://www.soyfoods.org/wp-content/uploads/Soy-Safety.pdf



http://www.soyfoods.org/wp-content/uploads/Soyfoods-Heart-Health-Protein-Chart-web2.jpg

http://www.soyfoods.org/wp-content/uploads/SwitchToPlantProtein%25201.31.11.pdf

http://www.soyfoods.org/wp-content/uploads/SwitchToPlantProtein%25201.31.11.pdf

http://www.soyfoods.org/wp-content/uploads/shopping-for-soy-graphic.pdf

http://www.soyfoods.org/wp-content/uploads/Soyfoods-Label-Claims-article.pdf

http://www.soyfoods.org/wp-content/uploads/Soyfoods-Label-Claims-article.pdf

http://www.soyfoods.org/wp-content/uploads/2016SimplySoyfoods-SoyfoodsMonth-recipebook.pdf

• After exercise, the intake of complete protein is key to muscle building and repair. Soy-based foods and beverages provide the high-quality protein necessary for protein synthesis in a more sustained release of amino acids than whey.i

• Soy, whey and casein have different rates of amino acid absorption, making the prolonged release of soy-dairy blend ideal for long-term increase in lean muscle mass. i

• Exercise creates an imbalance between oxidant and antioxidant levels, or oxidative stress, which can cause muscle soreness and damage. Antioxidant-rich soybeans have been shown to help protect muscle tissue from oxidative damage, aiding in athletic performance and muscle recovery.ii,iii

• For athletes, other than protein, iron is one of the most essential nutrients, aiding in the delivery of oxygen to muscles. One cup of soybeans contains nearly half of the daily recom-mendation for iron and 29g of protein.

• Soy does not contain estrogen. Overwhelming research shows normal consumption of soy (1-3 servings per day) does not cause unwanted effects on hormone levels or physical characteristics.iv

RD ADVICE: BUILD MUSCLE – NO STEAK REQUIRED

BENEFITS OF SOYFOODS FOR ACTIVE AMERICANS

What do four-time Mr. Universe Bill Pearl, triathlete Brendan Brazier and Ultimate Fighting Champion Mac Danzig have in common? Supreme muscular development for sure, but surprisingly these three top athletes follow vegetarian or vegan diets, as do a number of other top athletes around the world.

READ MORE from Wendy Marcason, RD, LDN in Eat Right, the publication of the Academy of Nutrition and Dietetics.

REFERENCES

i Reidy PT, et al. The Effect of Soy-Dairy Protein Blend Supplementation during Resistance Exercise Training. FASEB 2015.

ii Hill S, Box W, DiSilvestro RA. Moderate intensity resistance exercise, plus or minus soy intake: effects on serum lipid peroxides in young adult males. Int J Sport Nutr Exerc Metab 2004;14:125-132.

iii Brown EC, et al. Soy versus whey protein bars: effects on exercise training impact on lean body mass and antioxidant status. Nutr J 2004;8:22-26.

iv Kalman D, et al. Effect of protein source and resistance training on body composition and sex hormones. J Int Soc Sports Nutr 2007;23:4.

SOY FACTS: ILLUSTRATED INFOGRAPHICSGet the facts on these frequently asked soy topics, including:

• Men’s Health• Women’s Health• Phytoestrogens• Breast Cancer

• Package Labeling• Soymilk• Allergens• Thyroid Function

These “snackable” infographic two-sided cards are available for dietitians, sports and fitness trainers, and others upon request.

http://www.eatright.org/resource/fitness/training-and-recovery/building-muscle/build-muscle-no-steak-required%23.VM-gyJhOmCQ.email



https://youtu.be/RxNmsrRiL-U

http://www.soyfoods.org/good-for-you-2/soy-facts-illustrated-infographics/soy-facts-lower-the-risk-of-heart-disease-prostate-cancer

http://www.soyfoods.org/good-for-you/soy-facts-illustrated-infographics/soy-facts-postive-effect-on-womens-health

http://www.soyfoods.org/good-for-you-2/soy-facts-illustrated-infographics/soy-facts-phytoestrogens

http://www.soyfoods.org/good-for-you/soy-facts-illustrated-infographics/soy-facts-protective-against-breast-cancer

http://www.soyfoods.org/good-for-you-2/soy-facts-illustrated-infographics/soy-facts-soyfoods-package-labeling

http://www.soyfoods.org/good-for-you-2/soy-facts-illustrated-infographics/soy-facts-soymilk-compared-to-dairy-milk-alternatives

http://www.soyfoods.org/good-for-you-2/soy-facts-illustrated-infographics/soy-facts-soy-allergies

http://www.soyfoods.org/good-for-you-2/soy-facts-illustrated-infographics/soy-facts-thyroid-function

KEY FACTS TO KNOWSoy protein is the only high-quality plant protein with all nine essential amino acids, making it equivalent to animal protein. It’s a lean, green, protein machine.

• Soy is beneficial for athletic performance and muscle recovery, and is rich in antioxidant compounds that may help reduce oxidative stress associated with exercise. Soy protein provides an “intermediate” rate of amino acid release, and when combined with other proteins, such as whey and casein, offers a sustained delivery of amino acids to muscles.i Learn more in this SCANNERS article, The Role of Soy in the Performance of Active and Athletic Americans.

• Phytoestrogens—isoflavones in soy and other plants—have beneficial antioxidant properties. They are the source of much past confusion over soy safety; however, research confirms their safety in humans. Phytoestrogens are structurally similar to estrogens, but act differently and are much weaker.ii, iii In humans, studies show soy isoflavones may improve the health of arteries, prevent certain cancers including breast and prostate cancers, and reduce menopausal symptoms.iv

• The FDA says 25 grams of soy protein a day (2-3 servings), as part of a diet low in saturated fat, may reduce the risk of heart disease. A serving is: 1 cup soymilk or cultured soymilk “yogurt”; 1/2 cup cooked soybeans, edamame, tempeh or tofu; 1/3 cup soynuts; a soy-based protein bar; or a veggie burger.v

Help your clients reach their nutrition goals by including high-quality soy protein throughout the day with the Simply Soyfoods Quick and Easy Recipes booklet or with hundreds of fun recipe ideas on Pinterest.

MYTH BUSTERSCLEARING UP CONFUSIONS OVER SOY

The Academy of Nutrition and Dietetics SCAN DPG released a fact sheet with some facts about soy to share with your clients. DOWNLOAD IT HERE.

REFERENCES

i Reidy PT, Walker DK, Dickinson JM, et al. Protein Blend Ingestion Following Resistance Exercise Promotes Human Muscle Protein Synthesis. J Nutr. 2013;143: 410-416.

ii Sacks F, Lichtenstein A, Van Horn L, Harris W, Kris-Etherton P, Winston M, AHA Science Advisory: Soy Protein, Isoflavones, and Cardiovascular Health.

iii USDA. Soy Phytochemicals: Chemistry, Analysis, Processing and Health Impacts http://www.reeis.usda.gov/web/crisprojectpages/0194030-soy-phytochemicals-chemistry-analysis-processing-and-health-impacts.html

iv Kang J, Badger T, et al. Non-isoflavone Phytochemicals in Soy and Their Health Effect. J. Agric. Food Chem. 2010, 58, 8119–8133.

v AICR Foods that Fight Cancer, Soy, http://www.aicr.org/foods-that-fight-cancer/soy.html, Accessed July 10, 2014.

As part of a balanced diet, soyfoods have

a positive effect on women’s health

• Soy protein and fiber are beneficial in weight loss and can help reduce blood pressure. Research shows they increase satiety and decrease unhealthy snacking—decreasing total calories consumed.

• Soyfoods can promote bone health and help prevent osteoporosis. Many soy products have calcium, including edamame, soymilk, tofu and tempeh, a key nutrient to keep bones strong.

concerning heart disease, weight loss, certain forms of cancer, osteoporosis and menopause symptoms.



http://www.soyfoods.org/good-for-you/soy-facts-illustrated-infographics/soy-facts-phytoestrogens

http://www.soyfoods.org/good-for-you/soy-facts-illustrated-infographics/soy-facts-protective-against-breast-cancer

http://www.soyfoods.org/good-for-you/soy-facts-illustrated-infographics/soy-facts-lower-the-risk-of-heart-disease-prostate-cancer

http://www.soyfoods.org/wp-content/uploads/Soy-protein-for-your-Health-one-pager.pdf%3Futm_source%3DDevbridge%2BTEST%2Brecipeints%26utm_campaign%3D110a04dbfb-The%2BMighty%2BSoybean%26utm_medium%3Demail%26utm_term%3D0_3cad36c142-110a04dbfb-

http://www.soyfoods.org/wp-content/uploads/2016SimplySoyfoods-SoyfoodsMonth-recipebook.pdf

https://www.pinterest.com/soyfoods/


http://www.soyfoods.org/good-for-you/soy-facts-illustrated-infographics/soy-facts-postive-effect-on-womens-health

ACSM’s 20th Health & Fitness Summit & Expo Orlando, FL March 29th-April 1st, 2016

The Dr. Bortz Lecture: Act Your Age: Resistance Training for Health Aging

Jeffrey Janot, Ph.D., ACSM CEP and Nick Beltz, MS, CSCS, ACSM RCEP University of Wisconsin-Eau Claire

3 major takeaways:

• Sarcopenia is the natural loss of muscle and bone mass associated with aging but can be managed with proper implementation of resistance training.

• Resistance training can effectively improve muscular fitness in older adults with appropriate intensity and volume.

• By implementing non-traditional training modalities, we can decrease perception of effort during activities of daily living by improving functional capabilities.

Brief overview: Healthy aging is not completely reliant on improving muscular strength and endurance but rather slowing the natural loss of muscular fitness. Muscular fitness is the single most powerful factor in maintaining functional independence and preventing chronic disease in an aging population. Sarcopenia, the natural loss of muscle mass accompanied by a decline in bone mass with aging, is a major contributing factor to various diseases and functional disability. In this educational lecture, the latest research will elucidate evidence to support resistance training in older adults using various training modalities and exercise prescription principles.

I. Aging a. Epidemiological overview: what is the current state of aging in the US? b. Physiological changes associated with aging

i. Cardiovascular ii. Respiratory

iii. Metabolic iv. Skeletal muscle integrity v. Bone mass

vi. Environmental stress c. Aging and chronic disease development: “Burden of chronic disease”

II. Sarcopenia a. Definition

i. Role of sarcopenia in the development of select chronic diseases b. Physiology of sarcopenia: What are the related factors?

i. Motor unit remodeling and function/dysfunction of satellite cells ii. Anabolism vs Catabolism: what is the bigger problem?

iii. Role of diet and physical inactivity (lifestyle) c. Sarcopenia and its influence on functional disability

III. Resistance training program design for healthy aging a. Physiological benefits of resistance training for the older adult b. Alternative methods for improving functional capabilities in the older adult population

i. Power/speed/agility training – Fishbeck et al. 2013

ii. TRX/Suspension training – Janot et al. 2013 c. Resistance training program design

i. FITT-VP ii. Functional-focused

IV. Future directions and research in resistance training and aging a. Concurrent training in older adults b. HIIT/Metabolic training c. Resistance training for prevention of chronic disease associated with aging d. Resistance training and cognition?

The Ten Pillars to Burn Calories and Boost Fat Metabolism ACSM’s 20th Health and Fitness Summit

By Len Kravitz, Ph.D., University of New Mexico Suggested reading: Deyhle et al. (2014). The physiology of fat loss. IDEA Fitness Journal, 11(1), 36-44. Pilar #1 Get Up and Move More (Takeaway #1) Great reference: Get Up (2014) by James Levine Katzmarzyk, P.T. et al. (2009). Sitting time and mortality from all causes, cardiovascular disease, and cancer. Medicine & Science in Sports & Exercise, 41(5), 998-1005.

A. Too much sitting is hazardous to health B. New science of ‘sedentary behavior’ or ‘inactivity physiology’ C. Not the endpoint of physical activity continuum D. Adults/children spend ≥70% of waking day working at a desk, riding in a car, eating a meal,

playing video games, working on a computer, watching TV E. Canadian Fitness Survey: Mortality over 12-year period, 7,278 men and 9,735 women; 18-90 yrs. F. Leading causes of mortality: cardiovascular disease (CVD), cancer, respiratory diseases, injuries,

nervous system disorders, accidents, and other G. Major finding: Strong association between sitting and mortality; Mechanism: sitting results in

dramatic drops in lipoprotein lipase (captures fat from blood for fuel); leads to soaring levels of triglycerides; ‘Too much’ sitting also results in lowered levels of HDL-C and elevates risk to CVD

H. ‘Move a Little, Lose a Lot’ by James A. Levine, M.D., Ph.D. I. Research on NEAT (Non-Exercise Activity Thermogenesis): can burn 269 to 477 kilocalories/day Pillar #2 Start Metabolic Profiling (Takeaway #2) A. Action plan to combat sedentary behavior: create a metabolic profile for client: to do this track

everything a client does from wake-up time to sleep time (time everything out) B. Case study: Interventions at work to combat sedentary lifestyle: 1) stand up and walk around the

office every 30 minutes, 2) stand up and move every time the client needs to get some water, 3) walk to the farthest bathroom in the worksite facility, 4) take a walk break with every coffee break, 5) consider walking around the room when talking on the phone

C. Case study: Interventions at home to combat sedentary lifestyle: 1) get up and move during every commercial, 2) stand up and move for the opening segment of each TV show, 3) at the end of reading 4,6 or 8 pages, get up and walk around the room or house

D. Source for ideas for moving: Len Kravitz has developed a site: Don’t Sit, Get Fit http://www.unm.edu/~lkravitz/Pages/DoNotSitHome.html (here are some ideas: walk to work, walk during your lunch hr, walk instead of drive whenever you can, take a family walk after dinner, skate to work instead of drive, mow the lawn with a push mower, walk to your place of worship instead of driving, walk your dog, replace Sunday drive with a Sunday walk, park safely in the back of the parking lot, work and walk around the house, take your dog to the park, wash the car by hand, run or walk fast when doing errands, pace the sidelines at your kid’s games, walk the airport while awaiting your flight, walk to a coworkers desk instead of emailing or calling, make time in your day for moving, bike with family and friends, if you find it difficult to be active after work, try it before work, take a walk break with a coffee break, perform gardening and/or home repairs, avoid sitting for more than 30 min at a time, move around more at the grocery market, play with your kids 30 minutes a day, dance to music, walk briskly in the mall, take the long way to the water cooler, take the stairs instead of the escalator, go for a hike

E. Make sure you email Len ([email protected]) to get the metabolic profiling form F. “It is prudent to recommend that time spend in sedentary behaviors be minimized; however,

optimal levels of sedentary behavior to recommend are not currently know” Tips from Len G. Education Break: What is the most accurate equation to estimate RMR: Mifflin-St. Jeor (1990).

Men: 9.99xWt(kg)+6.25xHt(cm)-4.92xage+5 Women: 9.99xWt(kg)+6.25xHt(cm)-4.92xage-161

RMR is solved in Kcal/day Pilar #3 The Warm-Up Makes a Difference in Calorie Burning (Takeaway #3) Importance of warm-up: Thacker et al. (2004). The impact of stretching on sports injury risk: A systematic review of the literature. MSSE, 36(3), 371-378.

A. At rest skeletal muscles get 15-20% blood; moderate exercise they get 70%, Increased blood flow to skeletal muscle, better muscle contraction, increased dissociation of oxyhemoglobin, leads to earlier sweating, for better thermoregulation, increases speed and efficiency of neuromuscular messages, initiates carbohydrate and fat enzymes and hormones, reduces perceived exertion

B. What about E.P.O.C. (exercise after burn): multiply workout calories by 0.15 For example: 300 workout calories x 0.15 = 45 calories so Total Calories = 300 + 45 = 345 calories

Pillar #4 Resistance Training Burns Fat (Takeaway #4) Herrera, L. & Kravitz, l. (2009). Yes! You do burn fat during resistance exercise. IDEA Fitness J, 6(4), 17-19.

A. Researched fat burning during and immediately following resistance training B. Ormsbee, M.J. (2007). Fat metabolism and acute resistance exercise in trained men. Journal of

Applied Physiology, 102, 1767-1772. C. Looked at 8 trained (3 days/week for the last 2 years) males (24 years of age) D. Assessed 10-RM on chest press, lat pull down, shoulder press, leg press, leg extension, & leg curl E. Exp. trial: 3 sets of 10 reps using a load of 85-100% of 10-RM of exercises; 90-second rest

between sets F. Microdialysis: measure glycerol (index of lipolysis) in abdominal tissue G. Indirect calorimetry: Fat and carbohydrate (CHO) use; RER respiratory exchange ratio during and

after the workout; control trial of no exercise on a different day H. Results of kcal expenditure; elevated 10.5% after the workout I. Results of microdialysis; glycerol levels elevated 78% during and 75% after the resistance training

workout as compared to the control trial J. Results of RER (fat oxidation): Fat oxidation was 105% higher compared to control trial K. Why is fat oxidation elevated after resistance training? Elevated epinephrine and norepinephrine L. Important point: This fat oxidation effect has only been shown true with trained individuals

Pillar #5 Try the New HIIT-Circuit Resistance Training Programs (Skidmore 2011) (Takeaway #5) Aerobic CT CT HIIT-CT

(30-second lift: 15-second rest between sets)



5-minute cycle warm-up @ 60-70% HRmax



Bike 2:30 min @ 65-75% HRmax

Station A1 Station A1

Station A1 Station B2

30-second max cycle sprint 3-minute cool-down


Station C3 Station B2

Station B2 5-minute cycle cool-down 30-second max cycle sprint 3-minute cool-down


Station C3

Station C3 30-second max cycle sprint 3-minute cool-down

Bike 2:30 min @ 65-75% HRmax; 5-min cool-down

5-minute cycle cool-down

Station A1 (3 set of 13 repetitions) Station B2 (3 set of 13 repetitions)

Station C3 (3 set of 13 repetitions)

Triceps bench dips Standing biceps curl Standing dumbbell lateral raise Hip lifts Dumbbell squats Dumbbell split squat L leg Prone planks (30-second hold) Pushups Dumbbell split squat R leg Standing dumbbell bent-over row TIPS: Alternate Upper and lower body exercises and use more multi-joint exercises Pillar #6 Incorporate Split Training for Your Clients (Kaminsky 1990) (Takeaway #6) Protocol: Subjects completed 2 to 4 high-intensity exercise bouts about 15 to 20 minutes each at Intensity: Subjects worked at 70-85% of VO2 max or at a14-17 RPE. Each bout was separated by 5 minutes ACTIVE rest at a self-selected intensity. Complete on multiple modes. Duration: This workout takes about 45-90 minutes (depending on number of bouts completed) Pillar #7 Try the New Short Sprint HIIT Training from Australia (Boutcher 2011) (Takeaway #7) Warm-up: 5min of light exercise Workout: 8 seconds sprint followed by 12 seconds recovery (20-30 rpm) on cycle; light resistance on cycle; progressed to 20 minutes and then started adding 0.5 kg load increments Pillar #8 The Future of Cardiovascular Training: From a Molecular View (Takeaway #8) COMBINATION HITT AND CV CONDITIONING (Laursen 2010) Warm-up: 10min of light exercise Interval: 30seconds of sprinting (any mode) Rest Interval: 120second rest Work/Rest Ratio: 1-to-4 ratio. The work interval is 30seconds and the rest interval is 30seconds Frequency: Preformed continuously for 10-12min Note: After completion of interval session perform a 20-30min slow jog or walk at 50% HRmax Modify: Complete on multiple modes (cycling, elliptical training, running, rowing, stair stepping, etc.) Pillar #9 Train with a Weighted Vest (Tiumil 2011) (Takeaway #9) Protocol: Five, 1-min bouts on treadmill followed by 2-min recovery walking while wearing 5-7% body weight vest; then did a 30-min jog with no vest Intensity: Sprints are very hard intensity; recovery is very light; 30-min jog is 60% HRmax Duration: With intervals and continuous jog this is a 45-min workout Pillar #10 Do Multiple Maximal Lactate Threshold Training Bouts (Billat 2001) (Takeaway #10) Warm-up: 5-10min of light-to-moderate intensity exercise Protocol: Continuous aerobic exercise at 70-85% VO2max (14-17 RPE or Somewhat Hard to Hard) Duration: 20-min maximal steady state bout; recover 10 min; a 2nd 20-min maximal steady state bout Pillar #11 Do Variable Recovery HIIT Training (Seiler & Hetleid 2005) (Takeaway #11) Protocol: The subjects did 4-minute bouts of exercise (can do on any mode) at near maximal intensity with alternating recovery intervals of 1, 2 and 4 minutes Intensity: The near-maximal interval was hard to very hard, or around 17-18 on the RPE scale. The recovery interval self-selected Duration: This total duration can vary to individual goals Pillar #12 Do 30/30 HIIT Training (Gosselin 2012) (Takeaway #12) Warm-up: 5-10 min of light intensity exercise; Mode: Treadmill with no grade Work: 30 seconds at 90% VO2max (RPE =Very Hard); Relief Interval: 30 seconds at 35-40% VO2max (Walk, RPE=Light); Work/Rest Ratio: 1 to 1 ratio. Modification: Step-Wise Interval Training After each interval increase treadmill grade 3% and keep for work and relief interval Can complete on any mode increasing work with each interval Thank You

Worksite Health Promotion and Health Coaching Success: 10 Years of Data and Reflection

Erin Litton MA, CHES, ACSM-CEP Senior Behavioral Health Consultant, UI Wellness

University of Iowa Human Resources

1. Introduction a. Program Overview b. The University of Iowa

i. Academic Institution Profile ii. Worksite Profile

c. Integrated Health Management Model 2. LiveWELL:

a. Mission: To create and sustain a healthy campus culture at the University of Iowa through the development and delivery of best in class health and wellness programs for faculty and staff.

b. Types of Program Offered c. Qualities of a Health Coach d. Health Coach Process e. Health Coach Model f. Health Coaching Administration

3. 10 Year Historical Reflection a. Before Launch in 2006 b. Program Launch in 2006 c. Lessons and Data From Annual Reflections d. Ten Year Reflection e. Next Steps

4. Outcomes a. Return on Investment b. Adjusted Medical and Drug Claims Costs c. Risk Reduction and Absenteeism d. Population Health Behavior Changes e. Value on Investment

i. Annual Reports ii. Satisfaction

iii. Impact Stories iv. Outreach/Visibility v. Culture

5. Supportive Programs that Impact Culture a. Wellness Ambassadors b. Wellness Grants c. Wellness Heroes d. Well-being Question Set e. Employee Engagement f. Resilience

6. Next Steps

ACSM Health & Fitness Summit March 29 – April 1, 2016

ANTI AGING MIND BODY FUSION Presented by: June E. Kahn, B.S. CPT

June Kahn Bodyworks, LLC

You are only as young as your spine. Learn progressions, poses and practices to enhance vitality, balance, flexibility & awareness. Strengthen and stretch the back and surrounding core muscles to improve posture. Improve breathing through alignment of the head, chest and shoulders. Wake up your glutes, calves & feet and feel better and youthful!

TAKE AWAY POINTS

1. 3 Classifications of Active Aging Adult

a. Fragile b. Healthy c. Elite

2. The 6 elements of Active Aging Movements

a. Multi Planar b. Gait Training c. Brain to Body Response d. Strength & Flexibility Training e. Balance Training & Dynamic Stabilization f. Mind Body Approach

3. You are only as young as your spine

a. Spinal Flexibility b. Spinal Stability c. Spinal Mobility d. Pelvic Stability & Mobility e. Balance – Anterior & Posterior f. Balance & Kinesthetic Awareness

4. Wake Up Your Glutes

a. Why do they shut off? b. What is the result? Leads to back pain c. Process to keep them ‘turned on’

5. Enhance Flexibility a. Strengthening through Lengthening b. Fluid and Dynamic Movements c. Enhances ROM

6. Movement Progressions for the Active Aging Adult

a. Walking b. Wall Push Ups c. Torso Twists d. Standing Leg Balance e. Bridging f. Hip Extension

7. Why Mind Body Fusion

a. Bridging the Gap b. Affects REAL LIFE Muscle Function and Activities of Daily Living (ADL) c. Incorporates Neuroplasticity Training – Brain to body response d. Incorporates the use of the breath e. Slow and controlled movement f. Quality over Quantity

8. What type of disciplines?

a. Pilates b. Yoga c. Tai Chi d. Chi Quong

***For purpose of this program we will focus primarily on Pilates, Yoga and Physical Therapy techniques

What is Pilates?

Pilates is a series of non – impact exercises designed by Joseph Pilates to develop core strength, flexibility, balance and inner awareness.

History

The basis of all Pilates inspired methods comes from his teachings and his work. In 1926 Joseph Pilates emigrated to the United States and opened the first official Pilates Studio in New York City. It was not long before his Physical Fitness Studio started to attract Dancers and performers, athletes, models and actors who firmly believe they owed their strong, lithe bodies to the Pilates method.

Joseph Pilates referred to his exercise program as “The Art of Contrology” or muscle control to define his approach of using the mind to master the muscles. His program of exercises consisting of twisting, stretching, pushing, pulling and rolling movements both on the floor and other various forms of equipment was probably the first true mind-body methods brought to the Western World.

The Principles

It is important to remember that the manner in which exercises are performed is of far greater importance than the number of repetitions or force and overload applied. Quality will always be superior to quantity. It is inherent to what we want to accomplish.

The following principles and theories bring our focus back to where it needs to be. The purpose of what we wish to achieve. This is the foundation and basis for all Mind/Body exercise. The ten concepts and theories are as follows: Concentration Control Interdependence/Dynamic Stabilization Alignment/Centering Endurance/Stamina Balance Breath Purpose Progression Fluid Coordinated Movement

The Fundamentals:

Pelvic Tilts:

Seated to Supine (laying down on mat)

Targets - Increases the mobility of the lower spine and pelvis as well as, strengthens the lower

abs and back. Bridge:


Targets - Strengthens core muscles, specifically the back extensors. Hip Rolls (For Obliques):


Targets - Strengthens the obliques and other rotators of the torso. Flight:

Prone (lying face down)

Targets - Strengthens back extensors, preparation for swan type exercises and opposite arm,

opposite leg lift.

Cat:

All Fours

Targets - Stretches the back muscles, especially those along the spine.

The Essential Exercises

PILATES BASED: Half Roll Down Half Roll Up:


Targets - Strengthens the deep lower abdominal muscles, and is a preparation for the full roll

up. Progressive Hundreds:


Targets - Strengthens deep abdominal muscles, enhances breathing and coordination. Single Leg Stretch:


Targets - Strengthens deep abdominal muscles and enhances flexibility of the hamstrings. Double Leg Stretch:


Targets - Strengthens core muscles, while doubling the intensity to the core by using both

arms and both legs. Modified Criss Cross:


Targets - Strengthens obliques and the rotators of the torso. Double Leg Pull: Prefer use of mini ball under tailbone

Supine (laying down on mat)

Targets - Strengthens the deep abdominal muscles Leg Circles –

Supine –

Targets – Pelvic Stability and Hip Mobility Front Back Kicks:

Side Lying

Targets - Strengthens core and leg muscles and enhances hamstring flexibility. Leg beats

strengthens inner thigh muscles.

Side Lying Clam

Targets – Strengthens Glutes Modified Tricep Push Up on knees with Opposite Arm / Opposite Leg Lift:

All 4’s - Quadriped

Targets - Strengthens the back muscles. Prone Single Leg Kick on Forearms

Targets Spinal Stabilizers, Hamstrings, Upper Body Weight Bearing Plank - Hip Extension:

All Fours

Targets - Total body conditioner - strengthens the abs, back, arms and legs. Seated Diamond Stretch

Seated – Spinal Stretch Forward

Targets Spinal Flexibility and Hip Opening Mermaid:

Seated

Targets – The lateral flexors of the spine, a relaxing stretch Plank to Roll Up

Lunge with Rotation

Standing – Enhances torso rotation while strengthening glutes

Movement Progression and Class Formatting

Each class will include most of the exercises described. General exercise guidelines should apply when designing your program. These guidelines should be followed as set by ACSM (American College of Sports Medicine). Remember, medical clearance should be obtained before starting any exercise program.

Each class will begin with a warm-up. The fundamental exercises should be incorporated as part of the warm up. In the beginning phases of teaching this program, the class may consist mostly of the fundamental exercises and a few of the general exercises. As the concepts will be new to most participants, it is important that they gain a full understanding of them before moving on to the

rest of the exercises. The concepts alone can take up a large portion of the first class. As they become proficient at the fundamentals, then the exercises can be introduced with modifications, if necessary.

The body of the class will include the exercises in a progressive order. Execution of the exercises should be based on the strength and flexibility limitations of each participant. Each exercise has a base format. Variations from the base should progress only when the base can be performed in proper technique. In the beginning phases, some exercises can be omitted if necessary. A successful experience should be the ultimate goal for each participant.

After any exercises performed in a prone position that require extension of the spine and/or dynamic stabilization of the torso (ei: plank), move into a rest position such as Child’s pose or Little Piece of Heaven (as described by the Pilates method).

It is suggested that hamstring stretches be incorporated prior to leg circles to allow for enhanced range of motion for the exercise.

As a cool down, you may incorporate relaxation exercises such as hip rolls, lower back stretches or side lying arm circles to wind the class down. Relaxation and breathing techniques can also be incorporated to complete the mind/body process.

What is Yoga?

The word "yoga" comes from the Sanskrit root yuj, which means "to join" or "to yoke".

Yoga is a practical aid, not a religion. Yoga is an ancient art based on a harmonizing system of development for the body, mind, and spirit. The continued practice of yoga will lead you to a sense of peace and well-being, and also a feeling of being at one with their environment. This is a simple definition.

The practice of yoga makes the body strong and flexible, it also improves the functioning of the respiratory, circulatory, digestive, and hormonal systems. Yoga brings about emotional stability and clarity of mind. In the practice of Yoga the ultimate aim is one of self-development and self-realization

It is a tradition that dates back over 5,000 years. Apparently starting in India it traveled through Asia and finally reached North America. There are hundreds of variations and styles, each having a few unique qualities but still keeping within the original philosophy.

The most popular practiced today include: Ashanga – Flow Yoga Hatha – Stationery Poses with focus on Breath and Meditation Iyangar – Focus on Form, Alignment and Technique Kundalini – ‘Focus on the Breath and Breath Work Bikram – “Hot Yoga” - 26 sequenced movements practiced in a heated room Benefits of Yoga

Brings down stress and enhances powers of relaxation Boosts physical strength, stamina and flexibility Bestows greater powers of concentration and self control Inculcates impulse Control Helps in rehabilitation of old and new injuries Intensifies tolerance to pain and enhancing mental clarity Boosts functioning of the immune system Enhances posture and muscle tone Improves blood circulation Results in healthy, glowing skin Cleanses and improves overall organ functioning Bestows peace of mind and a more positive outlook to life Infuses a sense of balance and internal harmony

The sequence of exercises and postures counter balance the common physical stresses

A. Spinal Extension B. Spinal Flexion C. Spinal Rotation D. Scapular Retraction Hip and Knee Extension E. Dorsiflexion

Yoga focuses on neutral alignment to enhance kinesthetic awareness using:

A. Centering techniques B. Body Awareness techniques C. Movement Analysis

The movement patterns in Yoga:

A. Require simultaneous strength and flexibility B. Joint mobility vs. joint stability C. Movement quality vs movement quantity D. Movement integration vs movement isolation E. Implementation of Flowing Movement Patterns F. Undulating Format

The Physical Aspect of Yoga enhances internal stabilization of the torso and includes 7 Essentials to actively improve posture and alignment

A. Hip Hinge - Angle B. Active Back Extension - Arc C. Abdominal Stabilization – Combination of Arc and Angles D. Upper Body Weight Bearing – Combination of Arcs and Angles E. Breath Emphasis F. Pelvic Floor engagement G. Inner Thigh connection

Why Flow Yoga???

The easy incorporation into a fitness setting Undulating format allows for caloric expenditure Flowing components transition easily to a fitness group setting

The components and practical application of a Flowing Yoga Class: I. Practical Application – Creating Arcs and Angles

A. Body Awareness Warmup B. Introduction of Sun Moon Breath C. Introduction of Spinal Actions through Sun Salutation D. Incorporation of Modifications E. Implementation of flowing movement through transitions F. Interspersing of Yoga to Pilates postures through flowing transitions G. Undulating format

II. Create Mastery through Repetition to enhance motor learning, coordination

and balance

III. Movement Sequence:

Sun Salutation – Module A – Modified Module B – Full Salutation

Inhale, Extend Spine Exhale, Hip Hinge Forward (forward bend or chest on thighs) Inhale, Extend Spine to Pike Position (or hands on thighs) Exhale, step back to hover/chattaronga (or child’s pose) Inhale, scapular pushup (cobra or modified cobra) Exhale – hinge to inverted “V” or Downward Dog Inhale, step forward to Extend Spine to Pike Position (or hands on thighs) Exhale, Hip Hinge forward (forward bend or chest on thighs) Inhale, Extend spine in standing position Exhale – return to neutral

Breathing Technique: Your breath is the first thing you take in when you are born and the last thing that is taken away when we go….Breath gives us life, and is quite powerful when used correctly. It can help an individual excel in their physical and mental endeavors as well as calm and nurture in stressful situations. Breathing can be used in many ways, typically we breathe in only 10% of what we need. This is due to the daily stresses we encounter as we “rush” from one place to another or from thing to thing. In Yoga, we the breath is commonly used to calm and relax where in Pilates we use the breath for strength. So in Yoga, we tend to use Ujai technique (breathe in through nose and out through the nose) where as in Pilates we tend to use “Forced Expiration” (breathe in through the nose and out through the mouth). As instructors, our objective is to encourage our clients and students to breathe deeply, through the diaphragm, utilizing the breath through the movement and exhaling when one needs the most abdominal compression to support the movement progression.

Flexible Strength

Structure and Sequence

Modules A and B

The following chart shows the flowing sequence ofthe exercise positions of each module. Each module begins and ends in the neutral position, and flows like a bell curve. Positions 1 and 9 are equal, positions 2 and 8 are equal, positions 3 and 7 are equal. Positions 4, 5, and 6 are the more intense, and so, may be held for longer periods of time during the module.

Module A is an adapted version of Module B. Both are similar to a sequence in yoga

known as the" Sun Salutation." Module A is for less flexible people and for those just beginning the functional performance program. It is also recommended as the initial warm-up sequence for all class participants, so that everyone begins together, then later adapts individual positions according to their own needs and abilities.

Modules A and B are the framework for the integrated modules, during which

additional torso, upper and lower body strength and flexibility training exercises are interspersed throughout the 10 part foundational sequence.

. r

f J

1 .. ... ....... ... .....................

C'potlUcu

STRUCTURE Of MODULES A & B

**FLEXIBLE ART GRAPHIC is taken from the Reebok Flexible Strength Program, Developed by

Deborah Ellison, PT, based on Fluid Yoga.

Mind Body Fusion is the “art” of fusing two or more disciplines into a flowing, undulating progression of technique and creativity.

Tips:

Start with a progressive warm up that integrates both breathing patterns and techniques unique to each program

Begin standing and integrate rhythmic patterns that incorporate and point out all planes of motion

Incorporate progressive Sun Salutation methods and fuse Pilates movements that blend well together. Ei: Chair Pose to Standing Hundreds

Choose movements that you will use as ‘transitions’ from one move to another. Ei: Roll up to Saw, Downward Dog to Hi Plank.

When creating transitions, incorporate equal components of spinal flexion to spinal extension

End with a mindful cooldown that includes a mild meditation with rhythmic dynamic stretching. Ei: Tree Pose Pilates Side Lunges

Thank you for attending this workshop! My best to you all…..

June Kahn

[email protected]

www.junekahn.com Find me on Facebook – www.facebook.com/junekahn

Find me on Twitter - @juniebug1

Find me on Instagram – junekahn

Find me on Pinterest – junekahn

NOTES



http://www.junekahn.com/

http://www.facebook.com/junekahn

BOSU® Dimensional Core Training Advance your core training techniques by taking a global approach as you

explore multi-dimensional methods to effectively produce power and improve

core function. Learn a series of integrated core exercises to mobilize, stabilize

and strengthen the core, giving you greater ability to access the core for optimal

function. Dimensional core training delivers results!

Introduction:

Efficient movement is a constant give and take between mobility and stability,

with each segment of the body and its unique movement capabilities

influencing all the other segments. When mobility and stability are in balance,

and all segments are synchronized, movement is graceful and potentially

powerful.

Dimensional Core: Finding Balance

Mobility: Poor movement skills translates to decreased performance

strength

Stability: Poor movement stability puts undue stress on joints and

decreases movement efficiency

Sequential Innervation: Retrain to fire the muscles sequentially with a

balance of mobility and stability for efficient and effective movement

Defining Functional Core

Movement efficiency through the core body, this includes the trunk, hip and

shoulder complex.

Common Imbalances

Lower Body: - instability in the ankle and lack of dorsiflexion

decreases posterior chain activation when

standing

kneeling ankle

mobility

Hip: - weak hip stabilizers may cause inward knee

tracking

- lack of mobility decreases movement

performance and causes excessive strain to the

low back

low lunge

Low Back: - the low back requires stability to absorb and

generate forces

- lack of stability increases lumbar strain

prone stability

Mid Back: - the mid back requires mobility to decrease the

stress to the low back and shoulder girdle

prone mobility

Shoulder

Girdle:

- the shoulder girdle requires posterior stability

and anterior mobility for effective movement

and decreased strain to the shoulder joint

plank

BOSU® Dimensional Core Training

2

BOSU® Dimensional Core Series Position Warm Up

Standing spinal roll down, roll up with spinal extension

Roll down to squat to overhead reach, stand with chest opener

Kneeling on the dome with backstroke with forward lean

All 4’s cat and cow stretch, thoracic roll

Plank to thoracic extension

Downward dog with ankle mobility

Lunge to the right with hip opening, repeat on left

Forward bend, hip hinge to standing

Repeat

Standing on top of the

BOSU® Balance Trainer (BT)

Series 1: Walk This Way

Walking lunge forward with rotation on the floor, lunge onto the dome

Side squat with hip hinge forward bend, low squat with arms overhead

Low squat on top with hip hinge forward bend, lift to arm extended behind

the head

Reverse lunge to the floor, reverse lunge on the floor with arms overhead

Repeat on the other side

Standing behind the BOSU®

Balance Trainer

Series 2: Frog Rock

Wide squat to standing picking up the BT

In low squat, rock the BT forward, lift the heels, rock back into frog (advance

to lift the feet)

Jump back to plank

Pigeon stretch on one leg, lift up to plank in pigeon (repeat)

Jump to plank

Repeat pigeon stretch to plank in pigeon on the other side

Standing behind the BOSU®

Balance Trainer in platform

side up position (PSU)

Series 3: Lateral Lunges

Standing beside the dome in a lunge, stationary lunges with hands to the

floor and lateral flexion (repeat)

Hip to dome to lateral balance return to lunge (repeat)

Lateral traction (cross the bottom ankle and pull the top wrist)

Dynamic lateral lifts into lateral balance

Back to standing lunge


Standing to the side of the

BOSU® Balance Trainer

Series 4: Get Down

Stand on top of the dome, lift one leg to a knee balance, come to kneeling

knee balance

Hip hinge with leg extension balance, kneeling alternate arm and leg

extension (quadruped)

Quadruped to lateral balance (dynamic)

In lateral kneeling balance add a lateral crunch and bent knee hip

extension

Quad stretch to cross over hip stretch




Series 5: Core Twister

Stand on top of the dome and squat with core twist

Step to T stand, lift top leg

Step to lunge with lateral flexion

Step to T stand, lift bottom leg

Step to lunge with lateral flexion

Step to plank, recoil pushup to thoracic extension

Thoracic and hip extension rock

Plank, jump up on top of dome




BOSU® Dimensional Core Training

3

Series 6: Roll and Release

Kneeling to one side of the BT, place one shoulder on the dome, reach the

top arm over to the opposite side for chest opening and thoracic spine

extension. Repeat

In the same position lift the bottom hip off the floor in a side balance

position. Repeat the chest opening movement

Seated Figure 4 hip stretch

Shoulder bridge on the dome in a figure 4 leg position. Dynamic hip

extension (advance to hip circle)

Repeat the chest and thoracic mobility series on the other side

Shoulder bridge on the opposite side

Shoulder bridge with parallel legs with alternate vertical arm reaches (dome

compressions)

Shoulder bridge with parallel legs with alternate overhead reaches

Butterfly hip opener into dynamic hip extension with overhead reaches

Hip extension with external rotation of the hips

Kneeling beside the BOSU®

Balance Trainer

Series 7: Upside Down and Down Side Up

Part 1: Seated on the BT crossed legged, stretch forward bend, roll back to

cross legged supine balance, repeat with the other leg front, repeat

Add straight leg crunch and oblique crunch

Part 2: Plank with feet on the BT, jump to tuck, jump to plank

Oblique tuck to single leg balance R and L

Combine Part 1 and 2

Sitting on the BOSU® Balance

Trainer

Series 8: Mobility

Seated cross legged tri-planar triple stretch (diagonal front (R), lateral (L),

lateral (R), diagonal front (L), Lateral (R), Lateral (L), repeat) 3X

Seated twist to full body extension repeats 3X. Repeat with the other leg

crossed in front

Forward bend to reverse plank

Side lying dynamic chest opener and thoracic extension (repeat on other

side)

Dynamic squat to straddle forward bend, kneeling lateral adductor stretch

to cross over stretch, kneeling hip flexor stretch (repeat on other side)

Plank to hip extension (repeat on other side)

Wide lunge to twist to quad stretch (repeat on other side)

Rest in child’s pose

Sitting on the BOSU® Balance

Trainer

Learn More! Text BOSU to 66866

www.BOSU.com


March 29 – April 1, 2016

Step it Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities

David Brown, Ph.D., FACSM1

Senior Behavioral Scientist, Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity and Obesity, Physical Activity and Health Branch, Atlanta, GA [email protected] Summary

This presentation will provide an overview of Step it Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities, and will highlight examples of how each one of us can help to make physical activity the norm in the U.S. by promoting walking and walkable communities. America Walks and Every Body Walks, a collaborative of over 70 organizations, is calling for a walking revolution in this country. The Surgeon General’s Call to Action is a call for each one of us to be a part of this revolution. The Call to Action builds upon other seminal physical activity documents, including the 2008 Physical Activity Guidelines for Americans and the 2010 National Physical Activity Plan. As a result, highlights from these documents will also be discussed at times as they relate to promoting walking and walkable communities. As ambassadors of physical activity and walking, health and fitness professionals are encouraged to convey to our clients, worksite CEO’s, school administrators and Parent Teacher Association representatives, health and medical professionals, clergy and faith-based organizations, and other community stakeholders and policy makers the importance of regular physical activity to overall health, including:

• Adults who engage in regular physical activity, such as brisk walking, are at lower risk of heart disease and stroke, type 2 diabetes, breast and colon cancer, and depressed mood, compared to inactive adults.1-2

• “One third of U.S. adults, however, report no aerobic physical activity during their leisure time and less than half report levels of activity that meet the current aerobic physical activity guideline”.3-4

• A brisk walk is a great way to accumulate weekly minutes towards meeting the aerobic physical activity guideline.2

• “Walking is the most commonly reported physical activity among U.S. adults overall and also the most frequently reported activity among adults who meet physical activity guidelines”.4-6

“My goal for this call to action is for each one of us to recognize and embrace our role in building the great American Community, a place where being physically active is not only easier but also more engaging and fun” Quote from Vivek H. Murthy, MD, MBA, Vice Admiral, U.S. Public Health Service, Surgeon General, U.S. Department of Health and Human Services


• Promotion of walking is a viable public health strategy to help adults meet physical activity guidelines and gain health benefits.

As a result of this presentation, health and fitness professionals will learn about the evidence and rationale for Step it Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities7. Centers for Disease Control and Prevention (CDC) walking initiatives and select other community based examples of promoting walking and walkable communities will also be highlighted. The Surgeon General’s Call to Action will be discussed within the context of a socioecological framework and the sectors from the Physical Activity National Plan. You are asked to consider where you are positioned in the “framework” or “plan” in terms of where you live, learn, work and play and, now that you have been called to action, how will you step it up to promote walking and walkable communities?

Presentation Outline

I. Introduction and background information - including inclusion II. Brief - Historical overview of the Call to Action timeline III. Socio-ecological framework IV. Physical Activity

Why walking? – Evidence and rationale V. The 5 Goals of Step it Up! with examples of walking programs or walkability Goal 1. Make walking a national priority Goal 2. Design communities that make it safe and easy to walk for people of all ages and abilities Goal 3. Promote programs and policies to support walking where people live, learn, work, and play Goal 4. Provide information to encourage walking and improve walkability Goal 5. Fill surveillance, research, and evaluation gaps related to walking and walkability

Three take-away points

1. Walking can be a gateway activity to a more physically active lifestyle. Walkable communities can create a social norm in the U.S. that physical activity is important, and this social movement can relate to and reinforce the work of Health and Fitness Professionals.

2. Numerous programs, initiatives and collaborative partnerships that promote walking and walkability are contributing to an emphasis on a more active U.S. at policy, community, and individual levels. These represent increased opportunities for Health and Fitness Professionals to be involved in community physical activity initiatives and potentially expand your programs and grow your clientele

Like all parents, I am looking for easy, fun ways to keep my family healthy. Walking is an important option, and I believe all Americans want that choice. We need access to safe and convenient places to walk and wheelchair roll and a culture that supports activity where we live, learn, work, and play. Quote from Sylvia Mathews Burwell, Secretary U.S. Department of Health and Human Services

3. Health and Fitness professionals, are critical to the successful implementation of the Call to Action to make America walkable and to increase walking as one behavior that alone, or in conjunction with other physical activities contributes to active lifestyles among all Americans.

Selected References

1. Physical Activity Guidelines Advisory Committee. (2008). Physical activity guidelines advisory committee report 2008. Washington, DC: U.S. Department of Health and Human Services. Retrieve from

Physical Activity Guidelines Advisory Committee Report www.health.gov/paguidelines/Report

2. U.S. Department of Health and Human Services (DHHS). (2008). 2008 Physical activity guidelines for Americans. Retrieve from http://www.health.gov/PAGuidelines/guidelines/default.aspx

3. Schiller JD, Jucas JW, Ward BW, Peregoy JA. Summary health statistics for U.S. adults:

National Health Interview Survey, 2010. (2012), Vital Health Stat 10:252.

4. Berrigan, D., Carroll, D.D., Fulton, J.E., Galuska, D.A., Brown, D.R., Dorn, J.M…Paul, P. (2012). Vital signs: Walking among adults - United States, 2005 and 2010. Morbidity and Mortality Weekly Report, 61(31):595-601.

5. Kruger J, Ham SA, Berrigan D, Ballard-Barbash R. Prevalence of transportation and leisure walking among U.S. adults. (2008). Preventive Medicine 47:329–34.

6. Simpson ME, Serdula M, Galuska DA, et al. (2003). Walking trends among U.S. adults: the Behavioral Risk Factor Surveillance System, 1987–2000. American Journal of Preventive Medicine 25:95–100.

7. Department of Health and Human Services. Centers for Disease Control and Prevention. (2013). Walking as a way for Americans to get the recommended amount of physical activity for health. Federal Register 78(62):19491.

http://www.health.gov/paguidelines/Report/

http://www.health.gov/paguidelines/Report

http://www.health.gov/PAGuidelines/guidelines/default.aspx

Yoga to End the Day Mindy Caplan Your evening yoga practice will begin by sitting quietly and practicing slow deep breathing. After a gentle warm up the practice will move to standing yoga poses gently opening the hips, chest and shoulders before transitioning back to the floor for full body relaxing stretches and an amazing savanna.

2/23/2016

1

Progressive Systems to SMR

Progressive Systems to SMR Progressive Systems to SMR

2/23/2016

2



•

••

•


2/23/2016

3


•••



2/23/2016

4



1

Relax & Restore Foam Roller Training Irene Lewis-McCormick, M.S., C.S.C.S.

[email protected]

The benefits of Self Myofacial Release include: • Corrects muscle imbalances • Improves joint ROM • Decreases muscle soreness • Decreases neuromuscular hypertonicity • Increases extensibility of the musculotendinous junction • Increases neuromuscular efficiency • Maintains normal functional muscular length • Relieves joint stress

THE Cumulative Injury Cycle Kinetic Chain - This chain works, as an integrated, functional unit comprised of the soft tissue system:

• Muscle, tendon, ligament and fascia • Neural system

o Nerves and CNS • Articular system

o joints o Issues in the Kinetic chain will initiate the CIC, including but not limited to:

a) Muscle tightness and adhesions tend to restrict ROM b) Because of restrictions, joint motion is altered c) This changes normal feedback to the CNS d) Neural feedback is altered e) Neuromuscular efficiency is altered and compromised which leads to

poor movement patterns (faulty) inducing premature fatigue and potential injury

General Guidelines for SMR

The health and fitness professional should be proficient in these techniques prior to client instruction. • Hold each position 1-2 minutes for each side (when applicable). • Roll about 1 inch a second. • If pain is reported, stop rolling and REST on the painful areas for 20-30 seconds.

Continuing to roll when pain is present activates the muscle spindles, causing increased tightness and pain.

• Resting 20-30 seconds on painful areas (adhesions) will stimulate the GTO and autogenically inhibit the muscle spindles; reducing muscular tension and pain.

• Maintain proper Draw-In Position, which provides stability to the lumbo-pelvic-hip complex during rolling.

• Clients can perform SMFR Program 1-2 x daily. • Stretch the worked muscles after each SMFR session.

Take Away Points

• Rolling can be performed safely, daily and is ideal for pre and post exercise • For best results, approach rolling with a method as pictured below • Select rollers that are appropriate for your or your clients’ needs with respect to density,

roller length and cost


2

ILIOTIBIAL TRACT (IT Band) Position yourself on your side lying on foam roll. Bottom leg is raised slightly off floor. Maintain head in “neutral” with ears aligned with shoulders. Roll just below hip joint down the lateral thigh to the knee.

PIRIFORMIS Begin positioned with foot crossed to opposite knee. Roll on the posterior hip area. Increase the stretch by pulling the knee toward the opposite shoulder.

HAMSTRING Place hamstrings on the roll with hips unsupported. Feet are crossed to increase leverage. Roll from knee toward posterior hip while keeping quadriceps tightened.

QUADRICEPS Body is positioned prone with quadriceps on foam roll. It is very important to maintain proper Core control (abdominal Drawn-In position & tight gluteus) to prevent low back compensations. Roll from pelvic bone to knee, emphasizing the lateral thigh

GLUTEUS MEDIUS Position the body lateral on the roller with the side of the glut on the roller. The top leg should be crossed and flexed at the knee, over the back leg that is long and extended. The foam roll is placed just lateral to the anterior pelvic bone (ASIS). Roll along the side of the “butt.”


3

ADDUCTOR Extend the thigh and place foam roll in the groin region with body prone on the floor. Be cautious when rolling near the adductor complex origins at the pelvis.

LATISSIMUS Position yourself on your side with arm outstretched and foam roll placed in axillary area. Thumb is pointed up to pre-stretch the latissumus dorsi muscle. Movement during this technique is minimal.

RHOMBOIDS Cross arms to the opposite shoulder to clear the shoulder blades across the thoracic wall. While maintaining abdominal Draw-In position, raise hips until unsupported. Also stabilize the head in “neutral.” Roll mid-back area on the foam.

HIP FLEXOR Lie prone on the foam roller with your body weight supported with your arms. Maintain proper draw in position while you manipulate the roller over the tissue-dense anterior hip area. Stay just medial of the ASIS joint. Focus on the Psoas and flexor area down to the quadriceps and upward towards the iliac crest and PSIS joint.


4

ANTERIOR LEG (SHINS) Stabilize your body on top of the roller, gently rolling up and down across the front of the anterior lower leg. Particular helpful for those suffering from shin splints.

LUMBAR VERTEBRAE Lie supine on the roller using your arms and posterior muscles to support your body weight. Proper draw in position is important here in order to stabilize the spine. Roll from where “your belt crosses your pants” down to the PSIS joint.

CALVES Prop your body up on your arms/hands, being sure to support yourself with a shoulder joint that is closed and packed. Roll the extent of the calf, performing plantar and dorsi flexion in order to capitalize on the gastrocnemius and the soleus. It is common to get fatigued in this posture, so take breaks when necessary.

REFERENCES: Clark MA: Focus on Function: A Scientific Approach to Functional Flexibility. OPI Publishing. 1999. Clark MA: Focus on Function: A Scientific Approach to Neuromuscular Stabilization Training. OPI Publishing. 1999. Clark MA: Integrated Training for the New Millennium. NASM, Thousand Oaks. 2000. Corning-Creager, Caroline. Therapeutic Exercises Using Foam Rollers. 1997. Lang, Anette. Functional training with Styrofoam Rollers. PTontheNET.com.Articles. Egleid, Staffan; McCormick, Irene: The Complete Guide to Foam Roller Training. Championship Productions; Ames, Iowa 2004. Russell, Alan. Self-Myofascial Release Techniques. PTontheNET.com.Articles.

http://www.ptonthenet.com.articles/

ElizabethJoy,MD,MPH,FACSMMedicalDirector,ClinicalOutcomesResearch

IntermountainHealthcareSaltLakeCity,UT

ACSMSummit2016Orlando,Florida

Ifexercisecouldbepackedinapill,itwouldbethesinglemostwidelyprescribedandbeneficialmedicineinthena;on.

RobertN.Butler,M.D.Director,Na;onalIns;tuteonAging

“Leaveallthea*ernoonforexerciseandrecrea4on,whichareasnecessaryasreading.Iwillrathersaymorenecessarybecausehealthisworthmorethanlearning.”

WhydoweneedExerciseIsMedicine?

•  IntheUS,only14%ofwomenand27%ofmenengageinadequatePA

•  HalfofallUSadultswillbeobeseby2030•  PhysicalinacNvityisesNmatedtocause1in10prematuredeathsworldwide

PhysicalinacAvity:thebiggestpublichealthproblemofthe21stcentury-SteveBlair

ObjecAves

•  ProvideanoverviewoftheEIMprogram– DevelopmentandCorePrinciples

– Leadership,Reach&OrganizaNonalstructure

– ProgramElements

– EIMSoluNon:Phase2

– ApplicaNoninahealthcaresystem

OriginsofExerciseIsMedicine®•  LaunchedinNovember2007bytheACSMandtheAmericanMedicalAssociaNon(AMA).

•  DevelopedtoencourageprimarycarephysicianstoincludeexercisewhendesigningtreatmentplansforpaNents.

•  CommiZedtothebeliefthatexerciseandPAareintegralintheprevenNonandtreatmentofdisease.•  Shouldbeassessedaspartofmedicalcare,andintegratedintoeveryprimarycareofficevisit.

EIMLeadership&OrganizaAonalStructure

•  BobSallis,MD–  Chair,ExerciseIsMedicine

AdvisoryCommiZee

•  AdrianHutber,PhD–  VicePresident,ExerciseIs

Medicine

•  MarkStoutenberg,PhD–  EIMProgramOfficer

•  FelipeLobelo,MD,PhD–  EIMGlobalResearch

CenteratEmoryUniversity

•  EIMAdvisoryBoard–  19members

•  8EIMCommiZees–  ClinicalPracNce–  Science–  EducaNon–  SpecialPopulaNons–  Media–  CommunityHealth–  InternaNonalAdvisory–  CredenNal

EIMPhase1

•  2007-2013•  Infrastructure• Awareness

EIMPhase2

•  2014-•  ProgramDeliveryandEvaluaNon

• MetricsDriven

Acommunity-basedextensionofhealthcareforat-riskpopula;ongroupsaimedatphysicalacNvitypromoNon

byprovidingahigh-touchconNnuumofcare.

HealthcareProviders Health&Fitness

ProfessionalsandPrograms

PaAents

AcAveHealthOutcomes

1.PhysicalAcAvityAssessmentCliniciansassessphysicalacNvityduringpaNentvisitsusingthePhysicalAcNvityVitalSignembeddedinthestandard“vitalsign”secNonoftheelectronicmedicalrecord(EMR).

2.EIMPrescripAonAsimple,fastandeffecNvewebtoolforprescribingPAintheright“dosage”fortheprevenNon,treatmentandmanagementofanidenNfiedchroniccondiNon.

3.EIMReferralAweb-basedlistofprograms,professionalsandplacesthatofferaselecNonofPAparNcipaNonopNonsthatmeetindividualprescripNonneedsandpersonalpreferences.

HealthcareProviders:3StepProcess

•  ThePAVSisasimple2-3quesNonsetthatdeterminesweeklyfrequency,duraNonandintensityofphysicalacNvity(PA)

•  TheEMRsystemsogwarethenfactorsself-reportedfrequencyandduraNontodisplayPAasameasurementinminutesperweek(MPW)

1.PAAssessmentMedicalprofessionalsassessphysicalacNvitywiththePAVSembeddedinthevitalsignsecNonofanoutpaNentEMR

HealthCareProviders

ExerciseVitalSign

©2013IntermountainHealthcare.Allrightsreserved.

1.  Onaverage,howmanydaysaweekdoyouperformphysicalacNvityorexercise?

2.  Onaverage,howmanytotalminutesofphysicalacNvityorexercisedoyouperformonthosedays?days/weekXminutes/day=min/week(PAVS)

3.DescribetheintensityofyourphysicalacNvityorexercise:light=casualwalkmoderate=briskwalk vigorous=jogging

PhysicalAcAvityVitalSign

150

5 30

Light, moderate, vigorous

Start, increase, maintain

PediatricPhysicalAcAvityVitalSign

2.EIMPrescripAon

•  ThePAVSresultservesasastarNngpointfortheexerciseprescripNon

•  PAprescripNonrecommendaNonsarebasedonPAVS,medicalhistory,healthgoals,andbasedonAmericanCollegeofSportsMedicine(ACSM)guidelines

YourPrescripAonforHealthSeries

3.EIMReferral

•  EIMProfessionals:credenNaledinspecialpopulaNons,knowledgeofthehealthcaresystem,andlifestylebehaviorchangestrategies

•  PAIntervenAonProgramsdeliveredbyEIMProfessionalsin“moveandlearn”groupsessionsforat-riskpopulaNongroups

•  SourcedPAProgramsqualifiedbyEIMofferedinthecommunitybyrecognizedplacesanddeliveredbyEIMProfessionals

•  Self-directedPAProgramsthatcanbeperformedbasedonindividualpreference,healthrisk,abiliNesandenvironment.[Someofwhich(e.g.,web-basedprograms)wouldbequalifiedbyEIM.]

ReferralSources•  A majority of payers do not pay for PA programming, except for

some Medicare Advantage programs. •  Silver Sneakers

•  $30/month benefit that can be applied toward PA programming, such as a gym membership.

•  Physical therapists and dietitians are potential referral sources •  PT is appropriate for the patient with underlying neuromuscular/

musculoskeletal conditions •  Dietary counseling, combined with physical activity promotion may be

particularly appropriate for patients with weight management concerns and metabolic conditions (e.g. prediabetes, diabetes, etc)

•  Their services can be paid for through insurance

Clinic - END GOAL

No patient should leave a physician’s practice without:

An assessment of his/her physical activity

AND An exercise prescription or a referral to a qualified fitness

or allied health professional for further counseling.

EIMProfessionals

PAIntervenAonPrograms

LocalPAProgramResources

Self-DirectedPrograms

24

EIM:ConnecAngHealthcarewithHealth&Fitness

CredenAaledEIMProfessionals

•  CerNfied,experiencedengagementprofessionalsinthedeliveryofgroupexerciseprogramsessionsandsupporNngself-managedparNcipaNon

•  TrainedtodeliverPAIntervenNonProgramsthatincludestructuredphysicalacNvity,healtheducaNonandlifestylebehaviorchangestrategies

•  EIMcredenNaledforlow,moderateorhighriskparNcipantstomeetthehighstandardsrequiredbyhealthcareproviders,payersandpublichealth

hZp://cerNficaNon.acsm.org/exercise-is-medicine-credenNal

EIMNetworkConvenientaccesstocredenNaledEIMProfessionals,EIMqualifiedPAProgramsandEIMrecognizedPlacesforpaNentsandallinthecommunity

EIMNetworkBuildersTeamconsultsinthedesign,buildingandoperaNonofcommunity-basedEIMNetworksforaccesstophysicalacNvityprograms

EIMProfessionals

PAIntervenAonPrograms

LocalPAProgramResources

Self-DirectedPrograms

28

EIM:ConnecAngHealthcarewithHealth&Fitness

SafeandconvenientlocaNonsinthecommunityforat-riskpopulaNongroupstoparNcipateinPAprograms

EIMProgramsandPlaces

•  MunicipalCommunityCenters

•  Park&RecreaNonalFaciliNes•  HospitalWellnessCenters

•  MedicalFitnessFaciliNes

•  YMCAFacilityLocaNons •  PhysicalTherapyClinics•  CommercialHealthClubs

•  SchoolSystemFaciliNes

•  CorporateHealthCenters•  OtherAppropriateSpaces

Self-DirectedPhysicalAcAvity

AverageAmespentwalkingwas13minutesadayorabout90minutesaweek.

PayersofHealthCaredirecteligibles,employees&beneficiariestotheEIMNetwork

PublicHealthdirectthe

underservedtotheEIMNetwork

PAIntervenAonAdvisors

•  Enrollment•  AssessReadiness•  EIMPrescripNon•  EIMReferral

QualifiedPAIntervenAon

Programsdeliveredat

recognizedPlacesbycredenNaled

EIMProfessionals

EIMNetwork

PARTICIPATION

Tran

si4on

Eng

agem

ent

ProvidersofHealthCarePAVitalSign,

EIMOrderSet&OrderReferral

directpaNentstotheEIMNetwork

SharedbyProviders,PayersandPublicHealthtoprovideacriAcalmassofcommunityparAcipaAoninPAprograms

AddiAonalEIMPrograms

•  EIMonCampus•  MedicalStudentCurriculumandPhysicianTraining

•  EIMEvaluaNon

•  EIMEmergingLeaderProgram

hZp://www.exerciseismedicine.org

Summary

Session Outline ACSM Health & Fitness Summit & Exposition


Exercise Is Medicine: Making the Connection

Ben Thompson, Ph.D., FACSM, ACSM-EP-C Associate Professor, Department of Human Performance & Sport

Metropolitan State University of Denver [email protected]

Christine Wetzig, ACSM-EP-C, EIM-Level 2

Personal Trainer, Foothills Parks & Recreation Littleton, Colorado

Summary In 2014, the United States Preventive Service Task Force (USPSTF) recommended that adults who are overweight and have cardiovascular risk factors be referred for lifestyle interventions, including exercise. As a result, the Affordable Care Act (ACA) expanded required coverage to include such preventive services. This means that the services provided by qualified exercise professionals could potentially qualify for reimbursement by Medicaid, Medicare, and private insurers. The Exercise is Medicine (EIM) initiative and credentialing program can help to facilitate the collaboration between health and fitness practitioners. The purpose of this session is to inform fitness professionals about the EIM certification and how it can be used to establish a beneficial relationship with healthcare providers in order to promote a healthy lifestyle for their patients. Existing programs and ideas for EIM expansion will be discussed. Presentation Outline I. Brief Review of EIM Initiative II. Framework Supporting EIM A. Goals of the Affordable Care Act (ACA) B. Existing insurance provisions & challenges III. Existing EIM Opportunities for Fitness Professionals A. Cardiac rehabilitation B. Cancer exercise programs C. Older adult wellness D. Diabetes Prevention Programs (DPP) E. Parkinson’s programs


IV. Establishing Physician Connections A. Marketing focus B. Setting yourself apart with EIM Three Take-Away Points 1. The restructuring of the American healthcare system through federal regulations has shifted the focus of care toward preventive interventions for individuals who are at-risk for or diagnosed with metabolic disease. 2. Exercise professionals should be part of an integrated and comprehensive healthcare team, and as such, their services should be reimbursable expenses through Medicaid, Medicare, and private insurers. 3. EIM provides a pathway for exercise professional and healthcare providers to work together to provide prescriptive exercise for at-risk individuals.

Session Outline ACSM Health & Fitness Summit

March 29-April 1, 2016 How’s Your Vocabulary? A New Paradigm for Reaching Those with Weight Challenges by Mary Yoke, M.A., M.M. Prepare yourself to work with the fastest growing segment of the population! People with significant weight challenges tend to be marginalized by the fitness industry even though they desperately need and want our help. Come and learn the latest information regarding effective communication and movement techniques for clients struggling to get moving. I. What we’ve been doing well: A. Creating Guidelines and Recommendations for medically-oriented Health and

Fitness B. Focusing on athletes, fit individuals, and motivated individuals C. Credentialing health/fitness professionals to work with athletes and those who are fit and motivated D. Conducting exercise science research on people who like to exercise, and are usually young and fit E. Designing programs for people who like to exercise II. Meanwhile, in the real world . . . . . . A. There is a global pandemic of obesity B. 35.7% (78.6 million) Americans are currently obese

C. 50% of the U.S. population is predicted to be clinically obese in 2030 D. Insufficient physical activity is one of the 10 leading risk factors in global mortality E. Less than half (48%) of all adults meet the 2008 Physical Activity Guidelines F. Excessive sitting has been dubbed “the new smoking”, increasing the risk of diabetes, metabolic syndrome, heart disease, cancer, osteoporosis, etc. G. The recommended 300 minutes/week of moderate-to-vigorous physical

activity to reduce weight is unrealistic and meaningless for most obese adults; they cannot relate and so do nothing

III. Question: IS THERE A DISCONN ECT BETWEEN THE HEALTH/FITNESS

INDUSTRY’S FOCUS AND THE NEEDS OF THE REAL WORLD? Do we need a new way of thinking in order to help those who need us the most?

IV. Findings from an unpublished 2015 Qualitative Study: A. Main research questions: What types of physical activities are pleasurable and feasible for sedentary, overweight, middle-aged women? Is there a difference between women who perform regular physical activity (doers) and those who do not (non-doers) in terms of their activity preferences and physical activity descriptions? B. Population studied: 35-65 year-old weight-challenged women with full-time

sedentary jobs (N = 23) C. Method: 30-minute face-to-face interviews (informed by the Reasoned Action

Approach theoretical model) D. Selected Results: * Non-doers had significantly more perceived barriers * Non-doers were significantly more likely to report exercise as unpleasant * Non-doers were significantly more likely to want an exercise buddy

* The most pleasurable activities were gentle yoga, movement to music, stretching, and walking

V. Findings from the Literature A. Obese and overweight adults believe they have more exaggerated responses to exercise than normal weight adults (Wingo et al, 2011), leading to fear and avoidance of physical activity B. Obese women are less likely to enjoy exercise and to report that their weight makes exercise difficult (Leone & Ward, 2013) C. Obese clients do not feel their practitioners fully understand how much they struggle with their weight (Wadden & Didie, 2003) D. Feeling good about physical activity (having a positive affective response) is associated with more stable intentions and increased motivation to be

active (Kwan & Bryan, 2010) E. There is a relationship between pleasure/displeasure and higher or lower intensity levels (Ekkekakis et al, 2011). Imposing a speed that is just 10% higher than what overweight women would have self-selected led to a significant decline in pleasure (Ekkekakis & Lind, 2006).

F. Having home (or workplace) exercise equipment helps facilitate regular physical activity for overweight women (Jakicic et al, 1999)

G. Goals associated with weight loss and appearance tend to be extrinsic and typically result in lower adherence and satisfaction with physical activity (Segar et al, 2006) H. Behaviorally oriented programs are essential, focusing on the “how”, rather than the “what”, to change (Cannioto, 2010). Goal setting is key, as are self-monitoring, cognitive restructuring, social support, stimulus control, contingency management, and problem-solving skills. Programs that do not focus on such behavioral techniques are rarely successful. I. Programs are needed that focus on the reduction of sedentariness, not just the initiation of moderate-to-vigorous physical activity (Prince et al, 2014) J. Everything counts—not just MVPA or “healthy steps”! VI. Terminology and Vocabulary A. Avoid loaded words such as fat, excess fat, obesity, heavy, and large-sized. Slightly better terms are weight, weight problem, or excess weight (Wadden & Didie, 2003) B. The words exercise and fitness may be problematic. Avoid terms such as

ripped, shred, killer, blast, detonate, bikini, steel, rock-hard, skinny, etc.—all of which can result in a focus on the external

C. 20% of obese study participants said they would find a new physician if their doctor used stigmatizing language. Many reported they feel judged, stigmatized, and disrespected by fitness professionals (Puhl et al, 2013).

VII. Recommendations 1. Promote walking and help clients to experience subjective pleasure and

meaning while walking (e.g. what are the good things about walking?) 2. Promote feel-good moves. 3. Help clients find immediate positive pay-offs. 4. Reduce the focus on weight and appearance. Instead, focus on moving, staying active, sitting less, feeling strong, resilient, and happy. Help clients tap into the huge source of pleasure that comes from feeling vital, dynamic, and alive in one’s body! References:

• Cannioto, R.A. (2010). Physical activity barriers, behaviors, and beliefs of overweight and obese working women: A preliminary analysis. Women in Sport and Physical Activity Journal, 19(1), 70-84.

• Centers for Disease and Control Physical Activity Fact Sheet: http://www.cdc.gov/physicalactivity/data/facts.html

• Church, T.S., Thomas, D.M., Tudor-Locke, C., Katzmarzyk, P.T., Earnest, C.P., Rodarte, R.Q., Martin, C.K., Blair, S.N., Bouchard, C. (2011) Trends over 5 decades in U.S. occupation-related physical activity and their associations with obesity. PLoS ONE, 6(5): 1-7.).

• Ekkekakis, P. & Lind, E. (2006). Exercise does not feel the same when you are overweight: the • impact of self-selected and imposed intensity on affect and exertion. International Journal of Obesity, 30.

652-660. • Flegal, K.M., Carroll, M.D., Kit, B.K. & Ogden, C.L. (2012). Prevalence of obesity and trends in the

distribution of body mass index among US adults, 1999–2010. Journal of the American Medical Association, 307(5), 491–97. Available online: http://jama.jamanetwork.com/article.aspx?articleid=1104933

• Jakicic, J.M., Winters, C., Lang, W., Wing, R.R. (1999) Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women: a randomized trial. Journal of the American Medical Association, 282(16): 1554-1560.

• Kwan, B.M., Bryan, A.D. (2010) Affective response to exercise as a component of exercise motivation: Attitudes, norms, self-efficacy, and temporal stability of intentions. Psychology of Sport and Exercise, 11:71-79.

• Leone, L.A., Ward, D.S. (2013) A mixed methods comparison of perceived benefits and barriers to exercise between obese and non-obese women. Journal of Physical Activity and Health, 10(4): 461-469.

• Prince, S.A., Saunders, T.J., Gresty, K., Reid, R.D. (2014) A comparison of the effectiveness of physical activity and sedentary behaviour interventions in reducing sedentary time in adults: a systematic review and meta-analysis of controlled trials. Obesity Reviews, 15: 905-919.

• Puhl, R., Peterson, J.L., Luedicke, J. (2013) Motivating or stigmatizing? Public perceptions of weight-related language used by health providers. International Journal of Obesity, 37: 612-619

• Segar, M.L., Spruijt-Metz, D., Nolen-Hoeksema, S. (2006) Go figure?: Body-shaping motives are associated with decreased physical activity participation among midlife women. Sex Roles, 55(3/4): 175-187.

• Swinburn, B.A., Sacks, G., Hall, K.D., McPherson, K., Finegood, D.T., Moodie, M. L. & Gortmaker, S.L. (2011). The global obesity pandemic: shaped by global drivers and local environments. Lancet, 378, 804-14.

• Wadden, T.A., & Didie, E. (2003). What’s in a name? Patients’ preferred terms for describing obesity. Obesity Research, 11(9), 1140-1146.

• Wingo, B.C., Evans, R.R., Ard, J.D., Grimley, D.M., Roy, J., Snyder, S.W., Zunker, C., Acton, A., Baskin, M.L. (2011) Fear of physical response to exercise among overweight and obese adults. Qualitative Research in Sport, Exercise and Health, 3(2): 174-192.

http://www.cdc.gov/physicalactivity/data/facts.html

http://jama.jamanetwork.com/article.aspx?articleid=1104933

www.MohrResults.com Kara I. Mohr, Ph.D. ([email protected])

Mindset, Motivation and Changing Habits Kara I. Mohr, Ph.D., FACSM

Behavior change can be a frustrating process for clients and health-fitness professionals alike. Does mindset create the foundation for success? Discover what the latest research tells us about mindset, motivation and how we can change even the most stubborn behaviors. Learn specific strategies to use with your clients to help them focus their efforts, tackle tough habits and change that behavior for good!

A. What is Motivation? 1. Increasing Client Motivation – is it possible? 2. Motivation – Action – Motivation snowball

B. Mindset

1. What does mindset mean? 2. Changing mindset – is it possible?

a. Tools b. Strategies

C. Changing Habits 1. 24 Hour Discovery Tool 2. Rituals and paired associations 3. Reward/Reinforcement 4. Repeat

D. Putting it Together for Clients

http://www.mohrresults.com/

Flexible Strength Presented by Carol Murphy

ACSM 2016

Description:This session will show you how to fuse dynamic stretching with total body training on the ball for a simple, smooth and serious workout that will develop core strength, stamina and stabilization for a functionally fit body.

Objectives:• Understand mobility and how it effects function and performance.• Benefits of stability ball in stretching• ACSM stretch recommendations and guidelines.• Experience the flexible strength workout

1. Mobility - Movement around a jointa. Active _____________________b. Passive ____________________c. Dynamic____________________

2. Improving Function through mobility training

3. Class design tips• Exercise selection • Exercise order • Balance

4. Benefits of stretching

5. Benefits of Stability Ball

6. ACSM Guidelines and Recommendations for stretching• Frequency - once per day, at least 2-3 days per week.• Intensity - stretch to the point of comfortable tension not pain, when muscles are warm• Time - 10-30 seconds per stretch, repeat each stretch 2-4 times, accumulating 60

seconds per stretch• Type - Static, dynamic, ballistic and PNF stretches are all effective

7. Guidelines for Stability Ball• In general a 55cm ball is recommended for this workout• When seated on the ball, the knees and hips should be level• A firmly inflated ball will create greater balance challenge. Under-inflating the ball will

modify the balance challenge.

Flexible Strength Workout Carol Murphy

STANDING1. Squat: ball down up [8]2. Core twist rl ctr [4] 3. Bounce Catch & Raise4. Balance & Rotate Ball O/H5. Full ball circle6. Side lunge r, l: Fig 8 /// Rotary T [3slow+2quick]7. Lunge R // face R // Lunge L // Face L8. Squat, down dog, squat, ball raise

SEATED9. Lumbar mobility [pelvis tilt anterior, posterior, lateral, transverse]10. C-Stretch [reach up, lean, up down]11. Side lunge // One arm reach, Hip Flexor // Hamstring12. Triangle // Saw

BRIDGE13. Hip extension + Chest stretch 14. Trunk curl INCLINE15. Front kick 2:2 // Fig four16. Trunk curl [flexion--neutral--extension--neutral]17. Hack squat // Trunk traction

SEATED18. Dips19. Balance / Adductor POB20. Tuck & Extend + Push ups [2:2]21. Trunk extension 21. Rotary Torso SIDE-LYING22. Lateral Trunk Flexion // Traction23. Lateral Neck 24. Hip abduction / flexion / extension [ud / f / b]25. Mermaid

KNEELING26. Lat roll out

REPEAT SIDE-LYING ON LEFT SIDE

PRONE PLANK27. Body slide [scapular depression] 828. Pike & Extend29. Opposite arm / leg + reach bk

SUPINE30. Hip extension [bent leg]31. Ankle flexion / extension32. Hamstring curls33. Fig 434. Butterfly // Froggies35. Hamstring Scissor Stretch + Rotary T [u-d-u-d-twist]

SEATED ON FLOOR36. Straddle ball [push fr, r, lean r]37. Fig 4 [r leg bent; twist r, r hand roll ball bk to open chest]

FORWARD BENDING / STANDING38. Hip extension [hands on ball]39. Hamstring stretch [heel on ball]

Thank you for attending Flexible StrengthContact Carol at www.carolmurphy.com

http://www.carolmurphy.com


_____________________________________________________________________________________________________ - 1 -

The Truth About Today’s Sports Nutrition Trends Tara Gidus Collingwood, MS, RDN, CSSD [email protected] www.dietdiva.net I. Contemporary Sports Nutrition

• The athlete’s diet strongly impacts his or her performance • Multitude of information available to us now, hard to know what is accurate • Sea of fad diets • Athletes typically seek information that could possibly give them a

performance edge to their competition • Determinants of reliable information: evidence based research vs. quackery • Registered Dietitians with Certified Specialists in Sports Dietetics (CSSD)

apply evidence based knowledge in exercise sports to improve performance of athletes

II. Common Diets and Supplements Probiotics: Microorganisms that provide health benefits for a host when

administered in adequate amounts

• Most common strands are Lactobaccillus and Bifidobacterium

• Doses measured in CFU’s: Colony Forming Units Claims to: Improve GI distress, enhance immune function, and improve performance in heat, improve bloating Sources: Dairy products (yogurt and kefir) , kombucha, kimchi, miso, sauerkraut Conclusion of Research:

• Effectiveness of probiotics are dependent on both strain and dose • Should contain several billion CFUs to increase likelihood of

adequate gut colonization • More is not better. Doses range from 1-20 million CFUs and amount

needed is dependent on strand.

Gluten-Free : Gluten is the common name for storage proteins (prolamins) found in wheat, rye, and barley

• Prolamins are toxic in people with food sensitivities and can cause damage to the GI tract in people with gluten sensitivities, leading to malabsorption of nutrients

• Gluten-Free diets are appropriate for Celiac Disease, wheat allergies, and non-celiac gluten sensitivity

Claims to: Better absorption of nutrients in GI tract in those with gluten allergies/ intolerances, prevent complications of celiac disease, provide health benefits and an ergogenic edge in non-celiac athletes Sources: baked goods, pasta, cereal, soup, soy sauce, seasonings, salad dressings,

http://www.dietdiva.net/

_____________________________________________________________________________________________________ - 2 -

prepared meats, beer, flavored coffees and teas, some candies Conclusion of Research:

• The diet benefits those with Celiac Disease, gluten sensitivities/intolerances (GI tract will not heal if gluten is not avoided)

• If these conditions are not present, GF diet is of no benefit • Nutritional concerns of GF diet include:

a. early bone disease b. products containing enriched ingredients c. deficiencies of iron, calcium, and B vitamins

Paleo Diet: Foods as close to natural state as possible. • Based on Paleolithic ancestors • Our genes were developed during Paleolithic era and have changed little since

that time Claims to: Normalize insulin, lower blood pressure, improve athletic performance, and lower risk of several chronic diseases The Diet: : lean meats, game and wild meats, eggs (6-12/week), seafood, fruits, vegetables, nuts/ seeds, oils Excluded: dairy, grains, legumes, starchy vegetables, salted foods, fatty and cured meats, sweets, soft drinks and fruit juices Conclusion of Research:

• Paleo diet does have healthy components such as fruit, vegetables, and nuts.

• The diet restricts whole grains/ legumes which is a great source of fiber, vitamins, and other key nutrients

• Also restricts dairy, good source of protein and calcium The Alkaline Diet and Alkaline Water: based on the pH scale, which is a measure of how acidic or alkaline something is on a scale 0 to 14 (7 being neutral).

• Developed in response to overly processed American diet • Foods are high in calcium, potassium, magnesium, and bicarbonate that

counteract acidic pH

The Diet: almonds, artichokes, asparagus, avocados, beets, broccoli, buckwheat, cauliflower, celery, cucumbers, flaxseed oil, green beans, leafy greens, lentils, millet, olive oil, onions, potatoes, pumpkin seeds, quinoa Excluded foods: alcohol, chocolate, coffee, dairy, eggs, fruits, mayo, peanuts, processed foods, refined vegetable oils, saturated fats, soy sauce, sugar, white flour Conclusion of Research:

• Food pH can influence urinary pH, but not blood pH • Alkaline diet promotes consumptions of fruits and vegetables, with less

emphasis of processed foods. • The claim that alkaline diet will alter blood pH, reduce bone loss, improve

athletic performance are still scientifically unsupported Caffeine: Most widely used stimulant in the world

• Ergogenic aid in athletics has been studied since the 1970s • Absorbed quickly into stomach and peaks in the blood within 1-2 hours Claims to: Extra boost of energy, promote wakefulness, aid sleep deprivation, provide cognitive and mood enhancement, and improve athletic performance

Sources: coffee, tea, soda, chocolate, energy drinks

_____________________________________________________________________________________________________ - 3 -

Conclusion of Research: • Benefits are recognized, but stimulant comes with side effects such as

dehydration, nervousness, anxiety, increased heart rate, higher blood pressure, GI distress, insomnia, addiction, and headaches

• Prior to competition or race day, try practicing with caffeine in your system at a low dose to determine how your body reacts to it.

• Caffeine is ergogenic for sustained maximal endurance exercise, and has been shown to be highly effective for time-trial performance

III. Sugar: When, Why, and How Much? Within the last decade, society has become more diet and fitness aware. With that, popular media has demonized sugars for people as a whole. Health professionals must take into account one’s activity evel, performance goals, and the type of sugar one is consuming before overgeneralizing dietary recommendations. When: Shortly before and during exercise lasting > 60 minutes Why: Sugar is fast, available energy for the cells to use as a fueling source. Having

enough available energy is pertinent to performance, and can even help the body spare liver glycogen and have a higher rate of carbohydrate oxidation.

How Much: 30-60 g/hr, endurance athletes may benefit with 90 g/hr on training longer than 2.5 hours.

IV. Hydration: • Sweating and evaporation of skin is how the body cools itself. • Thirst lags behind dehydration • Balance of water inside/outside cells is determined by sodium intake as well

other electrolytes: potassium, chloride, magnesium, and calcium • Sodium is primary extracellular electrolyte that helps to draw fluid into the cell

2016 ACSM Summit Under Eating and Under Performing Outline

Introduction o Overview of Common Nutritional Goals Associated with various Sports

Some examples of sports with an aesthetic component to them • Cheer • Dance • Swimming • Physique Sports

Some examples of sports that do not have an aesthetic component, but athletes will often seek to achieve an aesthetic physique

• Baseball • Football • Soccer

o Overview of Common Diet Strategies Popular Fad Diets

• Atkins • Cleanses • Intermittent Fasting • Paleo • Vegan

Common Nutrition Concerns Associated with Fad Diets • Restrictive in food selection, kcals, and nutrients • Do not promote appropriate nutritional decision making • Lack variety • Expensive • Often times lack legitimate evidence to support effectiveness • Can be harmful or dangerous

Extreme Nutritional Practices • Very low/no carb diets • Very high protein consumption • Very low energy intake • Food elimination

Inappropriate Relationship with Food • Binge eating disorder • Bulimia • Anorexia nervosa • Body dysmorphia

Overview of Physiology Related to Under Consumption

o Metabolic Adaptation Under consumption may lead to a 20% reduction in RMR or more Down regulation in enzymatic expression Down regulation in hormonal expression

o Musculoskeletal Loss of LBM Potential loss of BMD Increased risk of injury

o Psychological Potential for depression Lack of concentration

Nutrition o Overview of Common Nutrition Practices Associated with Competition

Common Nutrition Concerns • Should be sport specific and match training demands • Energy Intake

o Maintain sufficient energy intake to maintain sufficient nutrient intake

o Mifflin St. Jeor with activity factor o 30 – 60 kcals/kg bodyweight based on activity level o Consistently reassess and adjust as needed o Under consumption is a common practice which could be

detrimental to progress and health • Fluid/Electrolyte Balance

o Sodium is often unnecessarily restricted by competitors o Minimal sodium intake 1500 mg/day o Maintain proper hydration status o 25-35 ml/kg bodyweight per day

Common Nutrition Concerns in Nutrient Timing • Carb Loading

o Low to no carb intake for 3-4 days o Followed by excessive carb intake for 2-3 days leading to

competition • Sodium/Potassium Loading

o Very dangerous o Can be fatal o Sodium restriction/potassium loading for 2-3 days leading to

competition o Not recommended

• Dehydration Practices o Fluid restriction for several days leading to competition

Common Nutrition Concerns Post Competition • Binge Eating • Energy Intake

o Adjust accordingly to match current activity level • Transitions to Off-Season Nutrition

o Should be done in phases o Reverse Dieting o “Bulking”

• Metabolic Concerns o Metabolic damage o RMR may be reduced by 20% or more during process

Closing o Review of Focal Points o Answer Questions

Group X Trifecta

www.carolmurphy.com

Description Trifecta uses accessible, proven equipment in a fun and functional tri-planar workout that works for fitness enthusiasts of all levels.

Equipment Stability Ball, Bar, DB, Gliding Discs, Resistance Tube

Class Formats

Strength / Endurance

❑ ACSM Rep based 8-20 reps

❑ 1-3 sets

❑ 55-85% 1RM

Circuit

❑ Time based 30-60 seconds per block

❑ Efficient

❑ Metabolic effect

Program design

❑ Exercise Selection: appropriate a. technical & physical difficulty

❑ Exercise Order: chest, back, shoulders, legs

❑ Program Balance: muscle groups, planes of motion

❑ Must maintain proper form, alignment

Why Tri-planar?

❑ The body works to produce movement

❑ We coordinate many muscles across many joints

❑ Favoring one plane of motion can lead to poorly developed firing patterns and movement disfunction in the untrained planes

Functional Checklist

❑ Does it mimic or counteract daily life?

❑ Is it compound?

❑ Does it require active internal stabilization?

❑ Can it be modified?

Strength Template

ROUND 1 ROUND 2 ROUND 3 ROUND 4 MODECHEST BACK SHOULDERS LEGS

Circuit Template

ROUND 1 ROUND 2 ROUND 3 ROUND 4 MODELOWER UPPER CORE CARDIO REST

Workout 1 - Strength: Ball - Bar

ROUND 1- BALL BAR ROUND 2- DB ROUND 3- BALL

CHEST CHEST PRESS CHEST FLY COMBO

PUSH UP-1 LEG

BACK DEAD ROW LAT PULL OVER LAT ROLL + PIKESHOULDERS CLEAN & PRESS SHOULDER PRESS

+TRICEPS EXTKNEEL PUSH UP + LAT ROLL

LEGS SQUATS LUNGE HALO SKATERS + SIDE LUNGE REPEATER

Workout 2 - Strength: Tubing

ROUND 1- TUBING ROUND 2- TUBING ROUND 3- GLIDING

CHEST LOW TO HIGH FLY SSW- 1 ARM FLY PUSH UP “ X “ BACK 1 ARM ROW -HIGH SF- 2 ARM ROW PRONE SWIMSHOULDERS EXT SHOULDER RTN SF - W FLY DIAGONAL PUSH UP

OR DOLPHINLEGS SQUAT + ABDUCT SEE SAW SQUAT BRAZILIAN LUNGE

Workout 3 - Metabolic Strength Conditioning: Gliding discs

GLIDING :40 HARD :30 HARDER :20 HARDEST

CHEST PUSH UP TUCK PUSH UP TUCKLEGS SQUAT & REACH SQUAT JUMP 2 JUMPS / 2 CLICKSBACK BODY SLIDE SLIDE BK - ABDUCT SLIDE BK - ADDUCTLEGS CURTSY LUNGE BALL FRONT / TWIST DIAGONAL CHOP

Thank you for attending, if you have any questions please feel free to contact me at www.carolmurphy.com



1

Metabolic Surge Presented by Helen Vanderburg

Introduction

Learn a new group-training format to challenge your intermediate to advance participants. Metabolic training is showing fantastic results and you know that is what your clients want. This style of conditioning consists of very high intensity exercise done with very sort bouts of rest. Using body weight resistance exercises or whatever equipment you have available to develop a challenging workout.

The Back Story

HIIT is described by the increase in intensity to the maximal efforts over very short periods on time. This form of interval training is intriguing because, according to current research, it can yield a broad range of physiological gains, often in less time than high-volume continuous exercise (Daussin et al. 2008).

Rate of Perceived Exertion (RPE)

1 2 3 4 5 6 7 8 9 10

2 - 3: Very easy 4 - 6: Moderate 7 - 9: Hard to very hard 10 +: Maximum

Metabolic Conditioning Overview

- Anaeorbic Power (RPE 10+)

- Anaerobic Capacity (RPE 9-10)

- High Aerobic Conditioning (RPE 7-9)

Dynamic Warm up – 5-7 minutes Walk with lunge Walk to lunge and dynamic hip extension Skip with arm circles Skip with alternate arm swing Squats: reaches Shoulder opener

2

Low lunging with lateral flexion Forward lunges Lunge with dynamic hip drive Cross over step

Individual Challenge

Finish the Minute Fartlek Training on 1:00 increments A spontaneous portion of each minute high endurance to anaerobic capacity training RPE: 7-8/9

Exercise Selection

Burpee prep/Full body drops Total time 3:00

Knee lifts/ Knee tuck jumps Total time 3:00

Side shuffle/ Lateral power Total time 3:00

Copenhagen Interval :30/:20/:10 X 5 RPE: 7-8/ 8-9/10

Exercise Selection (Set 1) Exercise Selection (Set 2)

Alternate Rear lunge with arm reaches Alternating lateral squat

Power lunge Low lateral squat

Switch lunge Power squat

Surge Intervals :45/:15 RPE: 8/9

Box jump

Knee driver

Shuttle power knee

Partner Challenge RPE: 7-8/9

Partner 1 Partner 2

3

Sprint to line/ 10 Star Jumps Walking planks

Sprint to line/ 10 Switch lunges Froggers

Sprint to line/ 10 Volley block Lateral Push up (wide to narrow)

Sprint to line/ 10 Long Jump Hip thrusts

Team Challenge

AMRAP

As many rounds as possible in a particular time RPE: 8-9

Exercise Selection: Repeats for 5 minutes

10 Burpees

10 Push ups

10 Air squats

Team Challenge

Surge Intervals

RPE 9-10 RPE 7-8

Teams of 4 Time :15

1 person at high intensity

Time :45

3 people at moderate intensity training

Lunge pops Alternate lunge

Mountain climber Plank

Crab with alt. foot touch Crab

Drop clap push ups Slow push ups

HelenVanderburg

www.helenvanderburg.com www.fusion-fitness-fitnesss.com

Follow me on

NeuroMovement for Whole Body Fitness What does the latest science of neuroplasticity research

teach us?

Anat Baniel, M.A. and Neil Sharp M.D. [email protected]

Anat Baniel Method® NeuroMovement® Center, San Rafael, CA Session Description: Current Neuroscience-neuroplasticity research demonstrates the centrality of the brain in successfully achieving desired levels of fitness and in overcoming limitations and injuries. It calls on us to find ways to bring about positive brain change that leads to enhanced performance and expand our focus from a primarily “physical”/muscular model of fitness. Learn 9 principles, supported by neuroplasticity research, that provide the brain the CEO of our bodies and minds with new information, leading to immediate and often transformative changes. Acquire concrete tools to use immediately in your practice with all ages and levels of performance. Be at the forefront of brain change/fitness research. In addition, brief introduction of applications of NeuroMovement to working with children with special needs. Take Away Points:

1. Understand the role of the brain in organizing movement and becoming fit 2. Shifting the paradigm from exercise to movement. 3. Practical applications of brain plasticity principles in fitness training 4. Possible new horizons for research

What Are Brains For?

1. Organize all action. 2. Organize movement – Daniel Wolpert – The Real Reason for Brains

https://www.youtube.com/watch?v=7s0CpRfyYp8 3. Change and learn throughout life (can be positive or negative) 4. Be “apprenticed” – continue changing in response to experience

What Is Movement For?

1. Movement is the “language” of the brain 2. Movement is the primary source of information for the brain 3. Movement helps the brain self organize and structure itself and in turn the

brain controls movement and action.


https://www.youtube.com/watch?v=7s0CpRfyYp8

The Workshop Includes:

1. Exploration of the profound role of the brain in determining levels of fitness-physical cognitive and emotional for all ages.

2. Four NeuroMovement lessons – experience the power of your own brain to change and enhance your flexibility, strength and coordination.

3. The “9 Essentials” – Science based principles – that promote positive brain change leading to enhanced physical and mental fitness.

4. Practical tools to use immediately in your practice to help clients overcome limitations and reach new levels of performance.

5. Opportunity to develop a more holistic approach. 6. Opportunity to expand beyond the 30 minutes intense workout paradigm 7. Short Video Demonstration and discussion of the use of NeuroMovement

with Children – typically developing and special needs. Research References Black JE, Isaacs KR, Anderson BJ, et al. 1990. Learning causes synaptogenesis, whereas motor activity causes angiogenesis, in cerebellar cortex of adult rats. Proceedings of the National Academy of Sciences, USA 87: 5568–72. Crum, A.J., Langer, E.J. 2007. Mind-Set Matters: Exercise and the Placebo Effect. Psychological Science 18 (2): 165–171. Dreifus L. 2003. Commentary: Facts, myths and fallacies of stretching. Journal of Chiropractic Medicine 2(2): 75–77. Johansen-Berg H, Matthews PM. 2002. Attention to movement modulates activity in sensori-motor areas, including primary motor cortex. Experimental Brain Research 142(1): 13–24. Kuo Yu-Ling, et al. 2008. The influence of wakeful prone positioning on motor development during the early life. Journal of Developmental and Behavioral Pediatrics 29(5): 367–76. Mason, M.F., Norton, M.I., Van Horn, J.D., Wegner, D.M., Grafton, S.T., Macrae, C.N. 2007. Wandering Minds: The Default Network and Stimulus-Independent Thought. Science 315 (5810): 393-395. Merzenich M, M, et al.1996. Language comprehension in language-learning impaired children improved with acoustically modified speech. Science 271(5245): 81–84.

Moseley, G. L., & Flor, H. (2012). Targeting cortical representations in the treatment of chronic pain a review. Neurorehabilitation and neural repair, 26(6), 646-652. Moseley GL, Zalucki NM, Wiech K. Tactile discrimination, but not tactile stimulation alone, reduces chronic limb pain. Pain. 2008;137:600-608 Moseley GL. I can’t find it! Distorted body image and tactile dysfunction in patients with chronic back pain. Pain. 2008;140:239-243. Nudo RJ, Milliken GW, Jenkins WM, Merzenich MM. 1996 Use-dependent alterations of movement representations in primary motor cortex of adult squirrel monkeys. Journal of Neuroscience 16: 785–807. Recanzone G.H, Merzenich MM, Jenkins WM, et al. 1992. Topographic reorganization of the hand representation in cortical area 3b of owl monkeys trained in a frequency discrimination task. Journal of Neurophysiology 67: 1031–56. Schilling, MA, Vidal P, Ployhart RE, Marangoni A. 2003. Learning by doing something else: Variation, relatedness, and the learning curve. Management Science 49(1): 39–56.

Keli Roberts www.keliroberts.com [email protected]

Small Group Training Partner Play Benefits High caloric expenditure Trains multiple fitness components in a single session Enhances muscular strength endurance Improved cardiovascular fitness

Can be implemented in all training settings Increased EPOC Social environment FUN!!!

Functional Movement Defined Trains the body as an integrated whole through all planes of motion and focuses on whole body movement, with multi-muscle, multi-joint rather than isolated single joint exercise. Movements create demand input from the nervous system for balance, proprioception and motor learning. Five Functional Movements

1. Bilateral Squat 2. Single Leg Stance (gait/lunge/step

up) 3. Push (horizontal/vertical) 4. Pull (horizontal/vertical) 5. Rotate/spiral/twist

Planes of Motion 1. Frontal 2. Sagital 3. Transverse

http://www.keliroberts.com/



Exercise Variables Leverage

Intensity – Load

Progressions/regressions

Rest Interval

Exercise Selection

Exercise Order/training complexes

Speed of Motion

Planes of Motion

Momentum

Range of Motion

Time/Reps/Sets/Volume

Base of Support Changes

Arm/Leg Drivers

External Manual Resistance

Equipment Choices

Work-to-rest ratio

Partner Training 1. Fun Factor 2. External manual resistance 3. External anchor point 4. Coordination 5. Cooperation 6. Socialization

Considerations

1. Sweat 2. Touching 3. The ‘dud’ partner 4. Fitness/strength level differences 5. Height/mass/lever length differences

Goal Specific Program Design Dynamic Warm-up

Solo Exercise

Partner Exercise

Plyometric Exercise

Movement Complex #

Lower Body

Lower Body

Lower Body

Movement Complex #

Upper Body Upper Body Upper body

Movement Complex #

Core Bias Core Bias Core Bias




Workout Structure • Timed Exercises-3 minutes per complex • 45 seconds work-15 seconds recovery per exercise. • 2 - sets = 60 minute workout

Program Variations

1. Perform each exercise for 30-60 Seconds and 20-10 seconds of recovery

2. Do three exercises consecutively, recover for 15-30 seconds before next series

3. Do three series with little to no rest. Repeat for another set. Continue for entire workout, resting only after every three series

4. Perform entire program 1 x for a 30-minute workout 5. Perform entire program 2 x for a 60 minute workout 6. Vary length of work interval/rest interval to decrease or increase

intensity Dynamic Warm-up

Squat with overhead reaches

Squat touch down alt OH reach

Squat with knee hug

Squat with knee hug with rotation

Squat with butt kick

Side-to-side squat

Side-to-side lunge with alternating

shoulder rotation

Side-to-side lunges with multi-level

alternating reaches

Dynamic hip-flexor/hamstring

stretch

Lower back stretches with hands on

thighs

Thoracic rotation/adductor stretch

Side-to-side torso rotation

Alternating side-to-side reaches,

head facing forward

Dynamic chest stretch with

overhead reaches




Complex Solo Exercise Partner Exercise Plyometric Exercise Complex 1 Lower Body Bias

Medicine Ball Squat Swing

Chain-gang Squat Partner facing Jump Squat low 10 - high 10

Complex 2 Upper Body Bias

Medicine Ball Push-up and Roll

Partner Burpie push up, alternating high 5

Partner Push up and Toss

Complex 3 Core Bias

Plank to Side Plank

Rubber Resistance Resist Rotation Chop, Stance Variations

Partner Jump ½ Turn Rotate/Chop

Complex 4 Lower Body Bias

Medicine Ball Lunge and Rotate

Rubber Resistance Lunge and Pull

Partner Medicine Ball Jump Lunge and Toss


Medicine Ball Triceps Push up

Back-to-back Triceps push, Stance Variations

Partner Quadruped Dip/Jump and Switch

Complex 6 Core Bias

Medicine Ball Russian Twist 1-2-Stop

Medicine Ball Back-to-back figure-8 Rotation

Partner Lateral Toss

Complex 7 Body Bias

Medicine Ball Transverse Lunge Thread the Needle

Medicine Ball Lateral Lunge with Touch-down and OH Pass

Solo Lateral Jump Lunge and Smash-Down


Rubber Resistance Sword Draw/Curl

Facing Rubber Resistance Horizontal Abduction

Partner Smash-down Toss

Complex 9 Core Bias

Medicine Ball Feet on Ball Plank with Walk ups

Medicine Ball Plank and Roll. Predictable /unpredictable

Partner Sit-up and Toss



“To Flex or Extend? : The $1,000,000 Back Pain Question For Fitness Professionals” Peter Ronai, MS, RCEP, CSCS-D, FACSM

Clinical Associate Professor Exercise Science Sacred Heart University

[email protected] INTRODUCTION: Low back pain( LBP) is the 2nd leading cause of MD visits and disability and leading cause of physical activity limitations in persons <45 in the United States. Physical Activity (P.A.)/exercise program guidelines for persons with low back pain resemble those of persons without it. Clients with LBP can experience “movement directional intolerance/ preferences” during exercise requiring either trunk flexion, extension or neutral postures. Poorly tolerated exercise postures can exacerbate LBP and curtail participation in exercise/rehabilitation training and physical activity. Personal trainers must identify clients with “directional intolerance/preferences” and select and modify exercises to accommodate them, preferences and enhance their stability, fitness and function. Participants will perform exercises requiring minimal equipment, space and time. LEARNING OBJECTIVES: Participants will learn how to:

• Enhance physical fitness without exacerbating clients’ LBP symptoms • Design exercise programs which accommodate clients’ LBP movement directional

preference (Who are Medically Cleared to Exercise). • Recognize common signs of directional intolerance and movements/positions which

trigger and relieve them • Perform quick assessments of directional preferences and specific conditioning exercises

to enhance stability, fitness and function TAKE HOME POINTS:

-PA guidelines for clients w/ LBP resemble those of clients w/o it w/some exceptions -Exercise modifications/selections should accommodate directional intolerances/preferences -Clients w/increasing signs/symptoms of LBP should contact their MD/Healthcare provider -Clients must be medically cleared before exercising -Certified exercise professionals must work within their scope of practice I. Exercise/PA Guidelines & Goals for Persons w/LBP (Similar to Persons W/O LBP (ACSM GETP 9) -Endurance Training (pp. 180, 185, 2014) -Musculoskeletal Training -Flexibility Training -Neuromotor/Balance Training -No Single Exercise Approach Superior for LBP in the Literature (Individualized Approach seems Best)

II. General Exercise Considerations -Medical Clearance -Exercise Professional Scope of Practice -Communication w/MD/Healthcare Provider --Red Flags -When to Stop Exercise -Analog Scales (RPE, OMNI-RES-10), PAIN Scales) -“Two-Hour Pain Guideline”-Arthritis Foundation III. Spine Mechanics of Flexion & Extension (Small Accessory Motions in Healthy Spines) -Facet Joints Open/Flexion & Close/Extension -Foramen Widen/Flexion & Narrow/Extension (Normal in Healthy Spines) in small amounts -Discs Compressed Slightly w/ Posterior Migration/Flexion & Anterior Migration/Extension IV. CASE SAMPLES-INTRODUCTIONs (Flexion & Extension Intolerant Clients) A. Flexion Intolerance/Extension Directional Preference -Symptoms/ Triggers/Timing (Bending Forward, Sitting, Compression), Relief from (Standing/Extension) -Do’s –Upright Spine, neutral to moderate extension in standing and prone, side-lying, quadruped -Modify or Don’t Do’s-Motions requiring sitting, bending forward, reaching & twisting B. Extension Intolerant/Flexion Directional Preference -Symptoms/Triggers/Timing-(Standing, Overhead/Prone Work, Twisting) Relief - Supine /Seated &Flexion Do’s-Neutral/Flexed Spine, Seated, Supine, or Upright Supported W/Stability Ball, Side-lying -Modify or Don’t Do’s-Motions requiring standing or prone extension, overhead reaching, & twisting V. Example/ Exercise Selection Recommendations for Flexion & Extension Intolerant Clients Exercise Type Flexion

Intolerance Basic Flexion Intolerance Advanced

Extension Intolerance Basic

Extension Intolerance Advanced

Aerobic/Endurance Walking-level, Walking in Water

Eliptical Trainer, Stair Climber, Nordic Ski Machine, Jogging-Level, Deep Water Running, Swimming w/Mask

Nu-Step, UBE, Recumbent Bike, Water walking, Swimming on Back

Walking w/incline Upright Bike, Deep Water Jogging, Swimming all strokes as tolerated, Rowing Ergometry (w/out extension)

Resistance Upper Body

Standing Or Prone with External Support Chest Press, Row, Lat Pull-down Triceps Push Down, Reverse (Rear) Fly, Bicep Curl w/adjustable

Assisted or Body Weight Calisthenics, Pushups, Pullups, Inverted Rows, TRX, Free Weight, Chest Press, Prone Bench Row, Reverse Fly ,

Seated Machine or Cable or Supine Row, Chest Press, Lateral Shoulder Raise, Reverse/Rear Fly, Lat Pull-down, Triceps Push-down, Biceps Curl

Assisted or Body Weight Calisthenics, TRX, Seated Machine or Cable Exercises Weight/Dumbbell Exercises, Standing exercises w/neutral spine

Cable Column or Tubing

Shoulder Press (Bar) Biceps Curl w/Stability Ball Support

Resistance Lower Body

Body weight squats w/stability ball, lunges, Bridging, Prone Hip Extension, Clamshells

Hip Hinge, Squats, lunges, Stability Ball Hip Bridge, Leg Curl, Sled Push/Pull, * Overhead Squat

Bridge Progression, Seated Leg Press, Knee Ext./Flex., “Potty Squat, Modified Hip Hinge, Clamshells

Leg Press Sled, Smith Machine squats, lunges in neutral spine, Sled Push (neutral spine)

Trunk/Core “Bracing”, Hip Hinging, “McGill Big 3”, Prone, Quadruped, Static De-rotation (Paloff Press), McKenzie Extension progression, Clamshells, Hip Extensions

Prone Swimmer, Back Extensions, Hip Hinging, Paloff Presses (multiple positions/angles), Single Leg Bridges, “Stirring the Pot”/Sawing w/Stability Ball

“Bracing”, Dead Bug Progression, Supine Paloff Press, Glute Bridge Progression, 1/2 side plank, Clamshells,

Curl-ups, Paloff Presses (multiple angles), *Swimmer(w/trunk support), Stirring the Pot & Sawing w/Stability Ball (Modified) *AKA Birddog

Don’t Bend @waist or twist

Bend @waist or twist

Arch Back or Twist Arch Back or Twist

Breakout Session (Exercises That Can Be Modified to Accommodate Both Flexion/Extension Intolerance: *Abdominal Bracing *Dying Bug *Bridging Progression *Clamshells *Hip Hinging *RDL/Single/Double *Squat/Lunge Progression *Side Stepping (resisted) *McGill Big Three *De-Rotation Exercises *Wall Exercises *Upper Body in Pushup Position *McKenzie Extension *Williams Flexion *Russian Twist *Upper Body in Side Plank *Triple Threats *Wall Press (G.M.) *Shoulder T-Y-I-W’s *Shoulder ER (Bilateral) Suggested References: American College of Sports Medicine. Position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med Sci Sports Exerc 43: 334–359, 2011. American College of Sports Medicine. ACSM’s Guidelines for Exercise testing and Prescription, 9th Edition. Baltimore, MD. Wolters Kluwer. 2014 Brummitt J, Matheson JW, and Meira EP. Core stabilization exercise prescription, Part1: Current concepts in assessment and intervention. Sports Health: 504–509, 2013

Huynh L and Chimes GP. Get the lowdown on low back pain in athletes. ACSM’s Health & Fitness Jornal: 15-22, 2014

1

Lecture Outline ACSM’s Health & Fitness Summit - March 29th – April 1, 2016

“The Fitness Professionals Quiz: How Much Do You Know?”

James R. Churilla, Ph.D., MPH, MS, RCEP, FACSM

Brooks College of Health University of North Florida, Jacksonville, FL 32224

E-mail: [email protected]

Health and fitness professionals possess various levels of knowledge and expertise in the areas of exercise equipment, preventive medicine, risk factor identification, chronic diseases, exercise guidelines, exercise testing, and exercise prescription. In a relaxed, anonymous setting, the presenting faculty member of this session will ask participants between 30 and 40 challenging questions. The questions will cover various aspects of health and fitness and will be sourced from several ACSM publications (ACSM’s Certification Review, ACSM’s Exercise Management for Persons With Chronic Diseases and Disabilities, and ACSM’s Guidelines for Exercise Testing and Prescription). This activity will utilize both Power Point and clicker technology, which will allow for questions to be answered in ‘real time’ with polled results being displayed on an audiovisual screen. This forum will present information in inquiry format covering entry level, intermediate, and advanced health and fitness knowledge that ACSM fitness professionals should be utilizing with their clients and patients. Each session will have space for 75 to 100 participants. Participants will take part in this interactive forum on a first come first serve basis or a pre-session sign up through ACSM once on site at the Summit. Welcome and Presentation Objectives

o The following bullets briefly identify topics that will be included in the question and answer format.

o All questions will be ask in a randomized order. o Identify knowledge gaps to guide toward specific learning opportunities.

Questions Covering Exercise Equipment and Exercise Modes

o Variable resistance and cam technology. o Free weights and free weight loaded resistance equipment (lever technology). o Body weight exercises and core training.

Questions Covering Preventive Medicine and Risk Factor Identification o Client and patient populations. o Recognize and refer.

Recognize risk factors and use clinical judgment. Qualified fitness professional must understand what they can and

cannot undertake and know when to refer to a medical professional. Questions Covering the Most Common Chronic Disease Conditions

o Type 2 diabetes o Hypertension o Overweight/Obesity o Dyslipidemia o Special Topics

2

Questions Covering Exercise Guidelines and Recommendations o Current ACSM physical activity recommendations. o Current Department of Health and Human Services physical activity

recommendations. Total physical activity volume recommendations. Strength training recommendations.

Questions Covering Exercise Testing

o Who gets an exercise test? Why? o Sub-maximal and maximal exercise testing.

Protocols o Procedures and precautions. o Interpretation and application.

Questions Covering Exercise Prescription

o Utilizing test data properly. o Specificity of training.

Three Tips To Take Away And Implement In Your Job From This Presentation

• Following this interactive session, health and fitness professionals should have a greater breadth of knowledge in the areas of exercise equipment, risk factors, chronic diseases, exercise guidelines, exercise testing, and exercise prescription.

• Following this activity, health and fitness professionals should be able to identify gaps in their own personal knowledge regarding all areas covered during this inquiry format.

• Following this interactive session, health and fitness professionals should possess greater knowledge of how to properly utilize exercise-testing procedures and develop and implement sound exercise prescriptions based on ACSM guidelines for both apparently healthy individuals and those with common chronic diseases.

Selected References

• ACSM’s Certification Review, 4th Ed. • ACSM’s Exercise Management for Persons With Chronic Diseases and

Disabilities, 3rd Ed. • ACSM’s Guidelines for Exercise Testing and Prescription, 9th Ed.

Session Outline ACSM Health & Fitness Summit


Self-affirmation Theory for Positive Behavior Change By Mary Yoke, M.A., M.M.

Research has shown that the use of self-affirmation can help with multiple types of behavior change, including the increase of physical activity, healthy eating patterns, medication adherence, smoking cessation, and even improved study habits! We will review current findings and you’ll engage in several positive self-affirmation experiences. You will leave with renewed motivation and strategies that will help not only you, but your clients! I. What is Self-Affirmation Theory? A. Self-affirmation theory, proposed by C. Steele in 1988, is based on the idea that people tend

to react strongly (and sometimes irrationally) when they feel their identity, integrity, or personal adequacy is threatened. The self-affirmation approach has been shown to help individuals reduce negative responses to perceived threats, and reduce the likelihood that they will react with denial or avoidance to new ideas. Because evidence shows that individuals are more open-minded after affirming their values and character strengths, the self-affirmation theory holds potential for helping pre-contemplators move towards healthy lifestyle behaviors. Self-affirmation could be a precursor to attitude change, and therefore increase the intention to change.

B. Self-affirmation: a statement that affirms a person’s sense of global self-integrity, positive self-beliefs, purpose and/or core values. According to the self-affirmation theory, even a single affirmation can buffer against psychological threat, thereby allowing for healthier decisions.

C. Self-affirmation benefits: * helps to change negative and destructive subconscious thought patterns * keeps fears from inter-fear-ing * re-trains the mind to think in a more positive, optimistic way * focuses energy on goals and intentions * helps in the acceptance of life events that cannot be changed * improves self-esteem and confidence II. Self-Affirmation template: I am a ______, ______ (man/woman/person), living a _____, ______, _______ life, richly

rewarded for my ___________, moving towards a _______________, achieving my goals of

____________ . I am _________, _________, and _________. III. Research Findings

A. BMI, weight, and waist circumference decreased significantly in a university student self- affirmation group over 2.5 months, versus controls (Logel et al, 2012).

B. 45.1% of clinical populations (CAD, HTN, asthma) using self-affirmation techniques achieved successful behavior change, vs 33.6% of controls (Peterson et al, 2012)

C. 93 self-affirmed participants consumed significantly more fruits and vegetables over a 7-day period than controls (Epton et al, 2008).

D. 199 middle-school students significantly increased their GPA and maintained a high level of motivation for 3 years after a self-affirmation induction (Sherman et al, 2013).

E. People who had a self-affirmation induction rated themselves as being at higher risk for HIV and were more likely to purchase condoms and take educational materials (Sherman et al, 2000)

F. Relative to controls, self-affirmed smokers rated negative graphic images of smoking consequences as more threatening and personally relevant, and they reported higher levels of self-efficacy around smoking cessation (Harris et al, 2007).

IV. Take the Signature Strengths Test (from the Values in Action (VIA) Institute) (Peterson & Seligman,

2004). V. Working with Clients * Help develop an affirmations practice. Start with a plan. * Encourage clients to keep an affirmations journal and write in it every day for at least 3 weeks. * Use post-it notes or electronic reminders. * Suggest affirmations such as, “I make healthy choices.” “My body is healthy, whole, vital and strong.” “I honor my body and _______ (choose healthy foods) (choose to move it every 30 minutes).” “My body is always moving towards health and wellness.” VI. Affirmation Hints * Affirmations should be relatively short, brief, memorable, and always in the present tense. * Use positive words such as I am, Yes, Always, Can, Do, Accept, All. * Avoid negative words such as Not, No, Never, Can’t, Don’t, Won’t, Shouldn’t, But, Although, Instead, Despite.

*Start the day off with morning affirmations. End with affirmations before falling asleep. * Try saying affirmations out loud to yourself while looking in the mirror. * Use technology: send yourself regular text messages or type an affirmation into your screensaver.

TAKE-AWAY POINTS: 1. Regular self-affirmation can help increase physical activity and can be a significant predictor of behavior change. 2. A self-affirmation induction can involve writing a personal self-affirmation, or the affirmation of one’s most important values and character strengths. 3. A good self-affirmation is brief, positive, and worded in the present tense. References:

• Charlson, M.E., Boutin-Foster, C., Mancuso, C.A., Peterson, J.C., Ogedegbe, G., Briggs, W.M., Robbins, L., Isen, A.M. & Allegrante, J.P. (2007) Randomized controlled trials of positive affect and self-affirmation to facilitate healthy behaviors in patients with cardiopulmonary diseases: Rationale, trial design, and methods. Contemporary Clinical Trials, 28: 748-762.

• Cohen, G.L. & Sherman, D.K. (2014). The psychology of change: Self-affirmation and social psychological intervention. Annual Review of Psychology, 65, 333-371.

• Epton, T. & Harris, P.R. (2008). Self-affirmation promotes health behavior change. Health Psychology, 27(6): 746-752.

• Harris, P.R., Mayle, K., Mabbott, L., & Napper, L. (2007). Self-affirmation reduces smokers’ defensiveness to graphic on-pack cigarette warning labels. Health Psychology, 26(4), 437-446.

• Logel, C. & Cohen, G.L. (2012). The role of the self in physical health: Testing the effect of a values-affirmation intervention on weight loss. Psychological Science, 23(1): 53-55.

• Peterson, C. & Seligman, M.E.P. (2004). Character Strengths and Virtues: A Handbook and Classification. New York: Oxford.

• Peterson, J.C., Czaijkowski, S., Charlson, M.E., Link, A.R., Wells, M.T., Isen, A.M., Mancuso, C.A., Allegrante, J.P., Boutin-Foster, C., Ogedegbe, G. & Jobe, J.B. (2012). Translating basic behavioral and

social science research to clinical application: The EVOLVE mixed methods approach. Journal of Consulting and Clinical Psychology, 81(2), 217-230.

• Sherman, D.K., Hartson, K.A., Binning, K.R., Purdie-Vaughns, V., Garcia, J., Taborsky-Barba, S., Tomassetti, S., Nussbaum, A.D. & Cohen, G.L. (2013) Deflecting the trajectory and changing the narrative: how self-affirmation affects academic performance and motivation under identity threat. Journal of Personality and Social Psychology, 104(4): 591-618.

• Steele, C.M. (1988) The psychology of self-affirmation: sustaining the integrity of the self. In Advances in Experimental Social Psychology, ed. L Berkowitz, 21:261-301. New York: Academic.

1

ACSM Outline – Kim Schwabenbauer, RD, LDN, CSSD April 1, 2016

Whole Foods Vs. Sports Nutrition Products

Learning Objectives:

• State the sports nutritional needs of general exercise athletes, endurance athletes and strength based athletes

• Understand the benefits of including sports nutrition products pre-, during and post- workout

• Identify commonly used commercially available products and understand their uses

• Describe several whole food alternatives and their benefits, as well as, drawbacks

• Identify optimal fluids a physically active person could drink before, during and after exercise

• Understand how exercise intensity and the goal of the athlete is an important determinate in their decision to use each type of product

Why / When do we need sports nutrition products?

Why

o Stay hydrated

o Fuel exercise

o Promote rapid recovery

Why would someone want to consume whole foods?

Why

o Sheer consumption

o Engineered sports nutrition didn’t always exist

o Athletes may not like the “idea” of processed

o Phytochemicals

Hydration

• Keys to adequate hydration are both fluid replacement and sodium replacement

• For short duration (< 60 mins) water is an excellent choice

• For longer duration (> 60 mins) a sports drink (5-7% concentration)

o Sports drinks are consumed in greater quantities than water alone

o Provide both carbohydrates (blood sugar), sodium and other electrolytes and is better absorbed than water alone

Hydration

• Before Exercise: Drink 16-24 oz of fluid 2 hours prior to exercise and 15 minutes before activity drink another 8 oz of fluid

Concerns

• Whole foods cause GI distress

• Whole foods are too hard to carry

• Whole food isn’t “formulated” so it won’t work

When

• Before (top off fuel stores 30 mins – 3 hrs prior)

• During (exercise 1+ hr(s) in duration)

• After (promote recovery)

2

• During Exercise: Drink 4-6 oz of cold water every 15 minutes during exercise to delay fatigue, Exercise over an hour = sports drink (sports drink encourages drinking!)

• After Exercise: Drink 2 cups of water/sports drink for every 1 pound of sweat lost – get on a scale (sweat test)!

Competition Day Nutrition

• Muscle Cramping

o Muscle cramping are involuntary muscle spasms resulting from one or more of the following:

• Dehydration

• Sodium Loss (1000-2000mg per hour loss in some athletes)

• Fatigue (training program)

o Most think cramping = potassium

• So many athletes that have poor race performances, look at their water bottles after the race and no more than 2 sips were taken & very little sodium

Goal of Pre-Workout Snack (2-3 hours before)

• High carbohydrate meal/snack that is low in fat/fiber and that you have tried before (i.e. nothing new)

• 2-3 hours prior to exercise is ideal, 200-500 calories

• Decrease carbohydrate and calorie content of the meal/snack, the closer to exercise it is consumed (closer = smaller)

• Include some lean protein to enhance satiety and alleviate hunger (milk on cereal, yogurt etc)

Pre-workout snack (30-60 mins prior)

• Liquid easier to digest than solid, 100-200 calories

• Recommendations: sports gels/beans or chews, sports drink, small serving of fruit (orange, ½ banana)

• Individual tolerances may vary so trying different options is important!

During Exercise

• 1.1 g CHO / min is the maximum rate of carbohydrate oxidation (70g-90g CHO / hr)

• Consuming a mixture of carbohydrate sources such as fructose / glucose vs. one source

• Sports drink concentration of around 5-7% shown to have best absorption rates with least GI distress

Sports Gels

• Designed to deliver large amount of CHO in compact and easily consumed form

• Must have adequate amounts of water to dilute and lower osmolality

• Gels may be effective source of energy, but challenge is taking in enough fluid

• About 100 calories per package (25 grams CHO)

3

Guidelines for workouts 2 hrs. or longer

o 60–90 grams of carbohydrate per hour

o 800–1,000 milligrams of sodium per hour (up to 2,000 milligrams if you’re a salty sweater or racing in hot conditions)

o No more than 2–3 grams of fiber per hour

o 3 grams or less of fat per hour

Whole Food Options

• Raisins

• Dried fruit such as pineapple

• Dates

• Almonds

• Potatoes

• Bananas

Recovery Nutrition

• Goals within 45 mins – 2 hrs

o Rehydration (fluid and sodium losses)

o Re-fuel (glycogen stores)

o Resynthesize (provide protein for muscle rebuilding)

o Berardi and colleagues study – 55% more muscle glycogen 6 hrs post-training with carb-pro supplement 1 hr, 2 hrs and small meal 4 hrs after vs. large meal 4 hrs post (Berardi et al. 2006)

• Guidelines

o 1.2g carbohydrates / Kg bodyweight + 1 g protein / 4g carbohydrates

o Ideal is a 4:1 ratio of carbohydrate to protein (75g CHO / 19g PRO)

Summary

Ask yourself the important questions:

o Type of activity

o Duration of activity

o Intensity of activity

o Competition plans

o Convenience and other factors

• Crackers

• Baby food puree (an alt. to gels)

• Gogi Berries

• Pretzels

• Eggs

• Plenty of options for both – Time of year may play a role! Periodization!

• Experiment in training, track options post-workout

Enriching the Leader Within

Mary Kruse, MS President, HealthSource Solutions

[email protected] Crystal Miller

Director of Fitness Center Services, HealthSource Solutions [email protected]

We all are leaders, what makes people follow you?

Are leadership and management different?

Are leaders born or made?

What Makes and Organizations Personality? • Leadership style • Trust • Unwritten rules • Work dynamics • Empowerment • Engagement

Qualities of Great Leaders (brainstorm)

Why do people follow them? (brainstorm)

What do the Experts Say? • Strength Finders • What Really Works • Neuroscience of Leadership • The 7 Habits of Highly Effective People

Tools for Self-Discovery • Strength Finders • Myers Briggs • DISC profile • 7 F’s



Applying the Tools • Strength Finders - Personality traits • Myers Briggs - Preference for interaction and communication • DISC Profile – Understanding behavioral styles • 7 F’s - Blending important life elements

Small Group Discovery • Which one of these tools resonated with you most? • How would you apply it?

I Am From

• • •

Your Lenses Aren’t Theirs

Empower • Listen • Trust • Respect

Listen • Traits of a good listener • Motivational interviewing techniques • Group practice

Trust Building your emotional bank account

• Understand the little things • Keeping commitments • Clarifying expectations • Personal integrity • Apologizing sincerely

Respect (group discussion) • Fairness • Openness • Acceptance

Growing Leaders at HSS • Culture • Values • Connection • Recognition • Personal development

Take-A Ways • What resonated with you? • Keeping you accountable.

References:

Anchor, Shawn. (2010) The Happiness Advantage. New York, NY: Random House Publishing.

Batz, P. & Schmidt, T. (2012) What Really Works: Blending the 7F’s. Edina, MN: Beaver’s Pond Press, Inc.

Buckingham, M & Clifton, D. (2001) Now, Discover Your Strengths. New York, NY: The Free Press.

Covey, S (1990) The 7 Habits of Highly Effective People. New York, NY: Fireside Book.

Covey, S & Link, G. (2012) Smart Trust: The Defining Skill that Transforms Managers into Leaders. New York, NY: Free Press

Hedge, Jason (2013) Disc Training Workbook. Redding, CA DISC-U.org

Hirsch, S & Kummerow, J. (1998) Introduction to TYPE in Organizations, 3rd addition (Myers Briggs). Palo Alto, CA: Consulting Psychologists Press.

Miller, W & Rollnick, S. (2013) Motivational Interviewing, 3rd Ed. New York, NY: Guilford Press.

Stewart, John Parker (2012) 52 Leadership Gems: Practical and Quick Insights for Leading Others. Leadership Excellence.

Terry, Robert. (2001) Seven Zones for Leadership: Acting Authentically in Stability and Chaos. Palo Alto, CA: Davis Black Publishing

1

Fascial Line Flexibility Training

By Helen Vanderburg Heavens elevated fitness

2006 IDEA Presenter of the Year 2015/2013/2006/1996 CanFitPro Presenter of the Year

Introduction This full body stretch class will take you through static, active and dynamic stretching sequences that target the facial lines of the body. Gain understanding and practice facial line movement patterns to enhance performance, decrease tension and increase flexibility. This stretch base workout is suited for group fitness and personal training.

Anatomy Trains – The Fascial Lines – (Thomas Myers)

Muscles operate in an integrated framework within the fascial webbing that form traceable “meridians or lines” of fascia that distribute strain, tension, fixation and compensations

Understanding the patterns of myofascial meridians helps to restore function of the fascia and build a platform for performance

The Anatomy Trains or fascial lines gives musculoskeletal anatomy a 3D feel and describes how movement and force are distributed within the body as a unit

Fascial Line Flexibility

Encourage multidirectional movement in all planes of motions

Superficial Front line:

Superficial Back line:

Lateral line:

Spiral line:

Deep Frontal line:

Arm lines:

2

Standing dancers pose Crescent Lunge Up dog Cobra Supported shoulder bridge: Bolster Shoulder Bridge

Standing Forward bend Wide legged Forward bend Downward dog Seated Forward bend: static, facilitated, dynamic,

3

Standing lateral stretch Standing cross over stretch Lunge with lateral flexion Pigeon Seated twist Side lying side bend Seated side bend with lateral reach

Kneeling twist Lunge with a twist Supine lateral twist Supine spiral line stretch

4

HelenVanderburg

www.helenvanderburg.com www.fusion-fitness-training.com

Follow me on

Low lunge Camel pose Kneeling quad stretch Back bend

Child pose Kneeling twist Kneeling thread the needle Prone chest opener Side lying chest opener: dynamic in multiple planes, static

ACSM SUMMIT 2016

Health & Wellness Coaching: Evidence & Practice for Exercise Professionals

Margaret Moore & Gary A. Sforzo

Presentation Description This interactive workshop helps participants better understand health & wellness coaching and how coaching can be used in their practice. Material is aimed at exercise professionals (e.g., personal trainers, exercise physiologists) and health care professionals allowing them to consider adding coaching to their everyday set of professional skills to improve effectiveness with clients or patients. After the workshop, we expect participants will be able to confidently speak to clients about the potential role for coaching in their lives. Furthermore, workshop participants will leave with a sense of how to implement selected coaching skills and what the challenges are to implementing these skills. We expect to have ample time for some practicing of skills and questions. We aim to provide exercises to further hone coaching skills after leaving the workshop. A handout of useful coaching literature will also be provided.

Presentation Outline Overview

I) What is Health & Wellness Coaching?

Define it

Utilization & Rate of Profession’s Growth

New National Standards for Education and Certification

II) Does Health & Wellness Coaching Work?

Evidence for using with clients:

Weight Loss

Diabetes

Smoking Cessation

Exercise Behavior Change

III) What are the Challenges to Health & Coaching Research?

Sampling

Control Groups

Randomization

ACSM SUMMIT 2016

Health & Wellness Coaching: Evidence & Practice for Exercise Professionals

Margaret Moore & Gary A. Sforzo

IV) As an Exercise Physiologist or Personal Trainer Which Coaching Skills Can I Use in My Work?

The Four C’s of Coaching:

Connection (Mindful, Compassion, Positivity)

Curiosity (Inquiry, Reflections)

Confidence (Strengths, Resilience, Hope, Self-efficacy)

Change (Visioning, Goals, Support, Accountability)

V) What are the Potential Benefits and Challenges for Incorporating Coaching Skills in My Work?

Benefits

Client Motivation

Client Success

Professional Success

Challenges

Expert v. Coach

Extent of shift (Goals, Assessments, Programming)

Mastering the Skills

VI) What does the Future of Health & Wellness Coaching Look Like?

An Asset to the Health Care System

Potential for Growth & Career Opportunities

Private Practice

Medical Settings

VII) Summary and Conclusions

NO CRUNCH CORE

ACSM SUMMIT 2016

MELISSA LAYNE, MEd.

TAKE AWAY POINTS 1. THE CORE IS DESIGNED TO MAINTAIN STABILTY AND MOBLITY – THE CORE MUSCLES DECELERATE IN EVERYDAY ACTIVITIES MORE THAN ACCELERATE.

2. THE CORE ALLOWS THE BODY TO FUNCTION AS A COMPREHENSIVE UNIT WITHOUT THE FOCUS OF EXTENSION AND FLEXION AS LEARNED IN TEXTBOOKS.

3. THE SPINE EXPERIENCES STRESS FROM GRAVITY ALL DAY AND THE IDEAL WAY TO COUNTERBALANCE THIS MAY NOT BE TRADITIONAL CRUNCHES WHICH ARE KNOWN TO AGGRAVATE SURROUNDING STRUCTURES.

I. Introduction

A. Movements of daily life, sports and most weight-bearing exercise modalities require the spine to move forward and back, side to side and in rotation.

B. The core’s outer unit is referred to as a series of kinetic chains that allows the body to function as a comprehensive unit relative to the body’s center of gravity.

II. Anatomy Review (NOTE THE CORRELATION TO EXERCISES ON PAGE 2 OF OUTLINE)

A. Flexion by the rectus abdominus, obliques, and psoas group in the sagittal plane 1. RA will also elongate to absorb ground forces during running 2. ES will lengthen to fight the constant force of gravity

B. Extension by the erector spinae, multifidus and lats in the sagittal plane C. Lateral flexion by the quadratus lumborum, obliques and erector spinae in the frontal plane D. Rotation by the obliques and multifidus in the transverse plane E. Deep inner unit of transverse abdominus is responsible for breathing coordination and

spinal-pelvic stability

III. Traditional Ab Exercises and Cueing

** Bracing vs Drawing in. Both advocate decreasing motion from lumbar spine and increase motion from the hip and thoracic spine. Today we may need to train to decrease motion. An inability to move hips may injure the spine.

A. Planks and abdominal bridging strengthen the muscles that stabilize the pelvis, spine and rib cage.

B. Sit-ups, leg raises, crunches and side crunches activate the RA and obliques but when overused can aggravate back pain and possibly cause injury

C. Rotations through the lumbar spine can cause injury; most of the rotation should be moderated and decelerated by the gluteus maximus

a. Overall lumbar rotation is 13% b. T10-L5 is 2% c. Greatest rotation is between L5 and S1 = 5%.

IV. A Better Approach

A. Integrated strengthening exercise 1. Train the whole body to lengthen under tension to help decelerate the spine 2. As it moves into extension, side to side motions and in rotation

B. Eccentric work C. Create momentum D. Loaded intermittent training E. Gradual progression

1. Stability a. Maintain length in spine

i. Consider ANTI-extension exercises- teach the anterior muscles to stabilize against increased back extension

b. Initiate movement from hip complex ( large glutes will be involved) i. Train to decrease motion of spine, increase hip mobility

ii. Consider ANTI-rotation exercises- move hips without compromising spine

c. Reach with scapula if needed 2. Mobility

a. Add a feet position change i. Single leg movements are more muscle activity, more specific and

functional. Everything changes when you stand on one leg from an anatomical position.

b. Add power transfer 3. Resistance

a. Add load b. Increase load

4. Performance

V. NO CRUNCH CORE EXERCISES (see handout for over one hundred exercises – no crunches)

A. Hip hinge ball placements; one legged squat thrust

B. Parallel ball arches; Lunge back with same arm raises; renegade row; renegade curl, kettle pulls; stir the pot, unstable elevated long levers

C. Same side sways; monkey swings; monkey swings over the head

D. Walking w/ overhead load (strength of gluteus medius and minimus decelerate the shift of the pelvis and brakes the lumbar spine): rear lunges w/ rotation; oblique swings; stationary lunge w/ chop

MULTIPLANAR: Kettlebell swing into curtsey lunges, kettlebell swing into high rows, swing into clean, swing into clean and press, clean into swing and high press, clean into swing into lunge (front or back) with high press, monkey swings with pivot lunges; oblique swings with overhead press; stationary lunge with chop; surfer burpees

VI. Additional Techniques

A. Myofascial release

1. ten minutes

2. focus on calves, quads, hip flexors, glutes, abs, back, muscles of shoulders and arms

B. Stretches

1. calf stretch

2. quad stretch

3. hip flexor

4. ab, shoulder and arm stretch

5. glute and back stretch

6. arms, chest, glutes and back stretch

VII. Conclusion

A. If you want to create fluid, pain-free movement, you must move beyond individual muscle and joint explanations and begin to understand and embrace the complexity of human movement.

VIII. References

A. ACE: Pro-Source; December 2014 – Best Exercises for Great Abs and a Pain-free Back; Justin Price.

B. Brittenham and Taylor, CONDITIONING TO THE CORE, 2014. Human Kinetics, Chicago, IL. C. Cook, Gray. ATHLETIC BODY IN BALANCE; 2003. Human Kinetics, Chicago, IL. D. Delavier and Gundill, CORE TRAINING ANATOMY; 2012. Human Kinetics, Chicago, IL E. NSCA. DEVELOPING THE CORE; 2014. Human Kinetics, Chicago, IL.

first-time attendee sessionforms.acsm.org/summit2016/pdf/16hfse all handouts.pdf · walking...

Documents